维甲酸治疗急性早幼粒细胞白血病出现高白细胞症62例分析

An Analysis of Hyperleukocytosis Induced by ATRA in 62 Patients with Acute Promyelocytic Leukemia

目的 :总结全反式维甲酸 (ATRA)治疗 6 2例急性早幼粒细胞白血病 (APL) ,分析治疗中白细胞数量对ATRA治疗APL的影响。方法 :外周血白细胞小于 10× 10 9/L19例 ,单用ATRA诱导治疗 ,白细胞大于 11× 10 9/L43例 ,采用ATRA与化疗相结合治疗。结果 :43例出现高白细胞症 ,发生率为 6 9.4% ,其中外周血白细胞在 11～ 2 0×10 9/L者 ,2 0例获完全缓解 (90 .9% ) ;白细胞在 2 1～ 49× 10 9/L者 ,2 0例获完全缓解 (80 .0 % ) ;白细胞大于 5 0×10 9/L者 ,5例获完全缓解 (83.3% )。结论 :ATRA与化疗相结合 ,对ATRA治疗期间出现的高白细胞症是一种有效的措施 。

Objective: To investigate the effect of all trans retinoic acid(ATRA) on acute promyelocytic leukemia. Methods: 62 patients underwent the treatment experiment. Among them,19 cases with WBC counts below than 10×10 9/L were administered with ARTA alone. The other 43 cases with WBC counts more than 11×10 9/L were treated with the combination of ATRA with cytotoxic drugs. Results: Hyperleukocytosis was found in 43 of 62 patients (69.4%)? In the 43 cases, the CR rate was 90.9% in 22 cases with WBC counts(11～20)×109/L, 80.0% in 15 cases with WBC counts(21～49)×10 9/L, and 83.3% in 6 cases with WBC counts>50×10 9/L. Conclusion: The study indicate that ATRA in combination with cytotoxic drugs is an efficacious treatment of APL and could reduce the early mortality rate.