三氧化二砷联合化疗治疗急性早幼粒细胞白血病疗效分析

Efficacy analysis of arsenic trioxide combined with chemotherapy in the treatment of promyelocytic leukemia

目的对三氧化二砷联合化疗药物治疗急性早幼粒细胞白血病的临床治疗效果进行评价并对其安全性进行分析。方法选取自2010年1月至2011年6月接受治疗的首诊为急性早幼粒细胞白血病患者共46例,对所有的患者采用三氧化二砷诱导后,应用化疗药物米托蒽醌以及阿糖胞苷进行治疗。进行为期3年的随访收集资料并分析治疗效果,即对完全缓解率、三年内复发率、三年内生存率和死亡情况以及并发症情况进行相关处理后分析。结果在46例研究对象接受三氧化二砷联合化疗治疗后,有42例完全缓解,完全缓解率为91.3%。所有患者进行化疗治疗后,死亡4例,总并发症率为71.7%(33/46);第一年复发率为7.1%(3/42),第二年复发率为23.8%(10/42),第三年复发率为35.7%(15/42)。第一年病死率为2.4%(1/42),第二年病死率为9.5%(4/42),第三年的病死率为21.4%(9/42)。结论三氧化二砷联合化疗药物对急性早幼粒细胞白血病进行治疗后,能够显著提高患者的生存率以及生活质量,毒性反应小,完全缓解率高,用药安全,值得在临床推广应用。

Objective The aim of our retrospective study was to analyze the clinical treatment effect of rational evaluation and its safety based on 46 cases of acute promyelocytic leukemia with arsenic trioxide combined with chemotherapy drugs application. Methods Clinical data of patients to our hospital for treatment of first diagnosis of promyelocytic leukemia cells from January 2010 to June 2011 was retrospectively analyzed. After arsenic trioxide induced,chemotherapy drug mitoxantrone quinone and cytarabine were used for treatment. Data collection and treatment effect for a period of 3 years of follow - up were analyzed. The complete remission rate,recurrence rate within three years,three years survival rate,death,complications were related to the processing analysis. Results A total of patients were retrospective analyzed. After arsenic trioxide combined with chemotherapy in the treatment in 46 cases,there were 42 cases of complete remission and complete remission rate was 91. 3% . After chemotherapy in the treatment of all patients,4 cases died,and the total complication rate was 71. 7%（33 / 46）. First year recurrence rate of all patients was 7. 1%（3 / 42）. The second year recurrence rate was 23. 8%（10 / 42）. The third year recurrence rate was 35. 7%（15 / 42）. The mortality rate of all patients during the first year was 2. 4%（1 / 42）. Mortality rate during second year was 9. 5%（4 / 42）. Mortality rate during third year was 21. 4%（9 / 42）. Conclusion Arsenic trioxide combined with chemotherapy for treatment of APL can significantly increase the survival rate and quality of life. The poisonous side reaction is small. The complete remission rate is high. The drug is safe. Large range popularization and application is worth in the clinical practice.