三氧化二砷联合全反式维甲酸治疗急性早幼粒细胞白血病的临床观察  

Clinical Observation of the Combination of Arsenic Trioxide and All-Trans Retinoic Acid for the Treatment of Acute Promyelicytic Leukemia

作　　者：王俊和[1] 张凤[1] 杨艳丽[1] 纪淑仪[1] 

机构地区：[1]安徽省蚌埠医学院附属医院血液科,233004

出　　处：《实用全科医学》2004年第5期381-382,共2页Applied Journal Of General Practice

摘　　要：目的　观察三氧化二砷 (As2 O3)联合全反式维甲酸 (ATRA)治疗急性早幼粒细胞白血病 (APL)的疗效和不良反应。方法　As2 O30 .1 6mg·kg- 1 ·d- 1 ,静脉点滴 ,持续 4～ 6h ;ATRA2 5mg·m- 2 ·d- 1 ,分 2～ 3次服用 ,直至CR ,根据外周血白细胞数、不良反应等调整As2 O3和ATRA用量。结果　 38例患者中 ,35例CR ,CR率 92 .1 %。其中初治 2 9例 ,2 8例患者CR ,CR率 96 .6 % ;复发 9例中 7例CR ,CR率 77.8%。取得CR所需时间初治患者为 (2 5 .4± 5 .2 )d(1 8～ 39)d ;复发患者为 (32 .4± 7.3)d(2 3～ 56)d。结论　As2 O3联合ATRA治疗APL疗效好 ,不良反应少 ,达CR时间短。Objective To observe the efficacy and side effect of the all-trans retinoic acid (ATRA) and arsenic trioxide(As 2O 3) combination in acute leukemia (APL). Methods 38 patients were treated with As 2O 3 (0.16mg/kg for intravenous drop in 4 to 6 hours once a day), and ATRA were taken orally 25mg·m -2 every day (in two or three separate doses) until complete remission (CR). The doses were adjusted by white blood cell (WBC) count and side effects. Results 35 of the 38 patients achieved CR, the CR rate was 92.1%. 28 of the 29 newly diagnosed patients achieved CR, the CR rate was 96.6%. 7 of the 9 recrudescent patients achieved CR, the CR rate was 77.8%. The average time for achieving CR was 25.4±5.2 day (18～39day) in the newly diagnosed patients and 32.4±7.3 day (23～56day) in the relapsed patients. Conclusions The combination of As 2O 3 and ATRA in the treatment of APL can obtain a higher CR rate without intolerable side effects and a shorter duration for achieving CR.

关 键 词：三氧化二砷 全反式维甲酸 急性早幼粒细胞白血病 外周血象 骨髓象 

分 类 号：R733.71[医药卫生—肿瘤] R730.53[医药卫生—临床医学]