联合三氧化二砷序贯治疗急性早幼粒细胞白血病临床观察

The clinical observation of sequential therapy combining arsenic trioxide for patients vnth acute promyeiocytic leukemia.

目的:观察三氧化二砷(As2O3)序贯治疗急性早幼粒细胞白血病(acute promyelocvtic leuk-emia,APL,)的疗效。方法:8例初发APL患者经维A酸诱导缓解后,再予DA方案(柔红霉素、阿糖胞苷)、维A酸和As2O3序贯巩固强化治疗3年,观察持续缓解时问及As2O3的不良反应。结果:8例中,7例随访4-42个月,1例失访。随访的7例均处于完全缓解中,中数缓解时间为17个月。随访超过24个月者3例,仍持续缓解,持续缓解时间最长者已达42个月。此疗法不良反应轻。结论:联合As2O3序贯治疗APL,疗效良好,有望延长APL患者的持续缓解时间及无病生存时间。

Objective: To study the efficacy of sequential therapy combining intravenous arsenic trioxide in treating patients with acute promyelocytic leukemia (APL). Methods: Eight APL patients induced to complete remission by tretinoin and chemotherapy were treated with sequential therapy of arsenic trioxide combined with tretinoin and chemotherapy (daunomycin and Ara-C) for 3 years. Continual complete remission (CCR) and adverse effects of arsenic trioxide were followed. Results: Seven patients had been followed up for 4 to 42 months and one patient dropped out. All 7 patients were in remission with mean complete remission duration of 17 months. Three patients remained in remission after 24 months of follow-up, with the longest remission duration of 42 months. The adverse effects of arsenic trioxide were mild. Conclusion: Sequential therapy combining arsenic trioxide, chemotherapy and tretinoin is effective and may improve the CCR and disease-free survival of APL.