柔红霉素联合阿糖胞苷对急性早幼粒细胞白血病的疗效分析

The effect of daunorubicin combined with cytarabine on acute promyelocytic leukemia

目的:研究在维甲酸、亚砷酸联合诱导基础上,不同时间应用柔红霉素联合阿糖胞苷对低危组急性早幼粒细胞白血病(APL)的疗效。方法:初治急性早幼粒细胞白血病低危组患者23例,根据白细胞(WBC)计数变化调整化疗方案的合理应用时间,观察在白细胞上升至10×109/L(观察组)及20×109/L(对照组)时加用柔红霉素联合阿糖胞苷的作用效果,以达到提高完全缓解(CR)率,减少APL分化综合征(DS)、弥散性血管内凝血(DIC)等严重并发症的治疗目标。结果:两组初诊WBC计数比较,差异无统计学意义(P>0.05),但治疗后观察组中WBC平均上升速率及上升最高值均低于对照组,且观察组中的DS发生率低于对照组;观察组中位CR时间为26.3 d,对照组中位CR时间为39.6 d,观察组明显早于对照组;另一方面,两组DIC的发生率和CR率比较,差异均无统计学意义(P>0.05)。结论:根据白细胞计数变化(≥10×109/L)加用化疗,可提高低危组急性早幼粒细胞白血病诱导化疗的治疗效果,有效控制疾病进展。

Objective： To explore the effect of Daunorubicin combined with cytarabine on low- risk acute promyelocytic leukemia（ APL） on the basis of arsenic trioxide（ ATO） and all- trans retinoic acid（ ATRA）. Methods： The reasonable application time of three drugs was adjusted by the white blood cell in 23 newly diagnosed APL patients in low- risk group. Observe the effect of daunorubicin（ DNR） combined with cytarabine on acute promyelocytic leukemia when white blood cells rised to1 0 × 10^9/ L and 2 0 × 10^9/ L. Results ： There was no significant difference in the newly number of WBC between groups（ P〉 0. 05）. However,the WBC average rate of rise,the highest values and DS incidence in observation group were lower than those in control group. The median CR duration in observation group（ 26. 3 d） was significantly earlier than that in control group（ 39. 6 d）. There were no significant differences in occurrence rate of DIC and CR between groups（ P〉 0. 05）. Conclusion： Administrating chemotherapy according to the white blood cell count（ ≥10 × 10^9/ L） can raise treatment efficiency of APL and effectively control the disease progression.