成人急性早幼粒细胞白血病联合治疗的疗效观察

Observation on therapeutic effect of combination treatment on adult patients with acute premyelocytic leukemia

目的 :总结近10余年来诱导分化与细胞毒药物联合治疗成人急性早幼粒细胞白血病 (APL)的疗效 ,并对影响疗效的预后因素进行分析。方法 :将1988年11月～1999年6月以全反式维甲酸(ATRA)及细胞毒药物联合治疗的成人APL患者39例 (治疗组 ) ,与1988年11月以前用传统化疗方案治疗的APL23例 (对照组 )的疗效进行对照 ,并对治疗组中导致易复发的因素进行分析。结果 :治疗组及对照组的完全缓解率(CR)、3年无病生存率(DFS)及5年总生存率(OS)分别为82.0 %vs26.0 %(P<0.01);47.2 %vs7.4 %(P<0.05);42.4 %vs7.4%(P<0.05)。结论 :用ATRA加化疗对APL进行诱导、巩固、维持的新的治疗方案 ,其CR、DFS、OS及治愈情况均好于使用传统方案者 。

Objective:Summarizing the10-years treatment effect by using of differentiation induction agents in combination with cytotoxic agents on adult patients with acute premyeloˉcytic leukemia(APL)and analyzing the prognostic factors which influence the treatment effecˉtiveness.Methods:Comparing the group of39patients(experimental group)treated with all-trans retinoic acid(ATRA)and cytotoxic agents from Nov.1988to July1999with the group of APL23patients(control group)treated with traditional chemotherapy before Nov.1988;Anaˉlyzing the factors liable to cause patients to relapss.Results:The complete remission rate(CR),3-years disease-free survival(DFS),and5-years overall survival(OS)of the experimental group and control group are82.0%vs26.0%(P<0.01);47.2%vs7.4%(P<0.05);and42.4%vs7.4%(P<0.05),respectively.Conclusion:By applying the new method with ATRA plus chemotherapy agents to treat APL on induction,consolidation and maintenance,the CR,DFS,OS and curing effectiveness are more effective than the traditional one,having greatly improved the APL patients'outcome.