全反式维甲酸联合亚砷酸治疗儿童急性早幼粒细胞白血病疗效分析

Curative effect of all-trans retinoic acid in combination with arsenic trioxide for children acute promyelocytic leukemia

目的:评价全反式维甲酸(all-trans retinoic acid,ATRA)联合亚砷酸(ATO)治疗儿童急性早幼粒细胞性白血病(acute promyelocytic leukemia,APL)的疗效。方法:2009年8月至2013年4月于我院儿科就诊的APL患儿18例,将亚砷酸注射液(0.1%ATO)按6mg/m2稀释于50 g/L的葡萄糖溶液200-400 ml中,静脉滴注持续3-5 h,1次/d,ATRA 20-35 mg/(m·d),口服,3次/d。结果:18例患儿获得完全缓解(CR)率为94.4%;12例初治患儿均获得CR,6例复发患儿中5例获得CR。获得缓解时间(26.2±1.2)天,无明显不良反应发生。结论:ATRA联合亚砷酸治疗儿童APL疗效显著,有效缩短达到CR的时间,毒副作用基本可以耐受,本方案可以有效缩短治疗时间,降低患儿家庭经济负担,对患儿长期治疗具有重要作用,是一种经济有效的治疗方案。

Objective：To evaluate curative effect of all-trans retinoic acid combined with arsenic trioxide （ATO） for children acute promyelocytic leukemia.Methods：2009 to 2013 in our hospital 18 APL cases were treated by the arsenic trioxide injection （ATO） 0.1％ 6mg/m2 to 50g/L glucose solution with 200-400ml,intravenous drip for 3-5 h,1/d,ATRA 20-35 mg/（m · d）,oral,3/d.Results：18 cases were complete remission （CR） （94.4％）;12 cases were CR,6 cases were recurrent,5 cases CR.Remission time was （26.2 ＋ 1.2） days,and no obvious adverse reaction occurred.Conclusion：ATRA combined with ATO for APL children has very good curative effect,this scheme can effectively shorten the treatment time,is an economic and effective treatment.