砷剂治疗急性早幼粒细胞白血病诱发带状疱疹再激活的研究

Study on Herpes Zoster Reactivation Induced by Arsenic in Patients with Acute Promyelocytic Leukemia

目的:探讨急性早幼粒细胞白血病(APL)患者静脉应用三氧化二砷或口服复方黄黛片治疗后引起带状疱疹的再激活率。方法:回顾性分析西安交通大学第一附属医院血液内科2008-2019年收治的212例接受砷剂治疗的APL患者的临床资料,应用Kaplan-Meier分析、卡方检验、箱式图等对患者进行统计及分析描述,观察应用砷剂后引起的带状疱疹病毒的激活率。结果:排除早期死亡病例及早期自动出院的病例,在175例使用砷剂治疗的APL患者中,17例出现带状疱疹再激活,带状疱疹在应用砷剂后10个月内再激活的精确风险为9.7%。砷剂累计中位剂量6.2(2-12)mg/kg。结论:砷剂治疗可以诱发带状疱疹病毒较高的再激活率。

Objective:To investigate herpes zoster reactivation induced by arsenic in patients with acute promyelocytic leukemia(APL).Methods:The clinical data of 212 patients with APL treated in the Department of Hematology of the First Affiliated Hospital of Xi’an Jiaotong University from 2008 to 2019 were retrospectively analyzed to observe the activation of varicella zoster virus induced by arsenic.Kaplan-Meier analysis,chi-square test,and boxplot were used to analyze and describe the cumulative dose of arsenic and the time from the beginning of arsenic treatment to the occurrence of herpes zoster.Results:Excluding early death cases and early automatic discharge cases,17 cases developed herpes zoster reactivation in 175 patients with APL treated with arsenic,and the cumulative median dose of arsenic was 6.2(2-12) mg/kg.Precise risk of reactivation of herpes zoster with 10 months in APL patients treated by arsenic was 9.7%.Conclusion:Arsenic treatment can induce high reactivation rate of herpes zoster virus.