亚砷酸隔日静注治疗急性早幼粒细胞白血病  

Treatment of acute promyelocytic leukemia with intravenous arsenic trioxide

作　　者：孟秋[1] 王京华 凌丽[1] 张志南[1] 邹淑华[1] 

机构地区：[1]哈尔滨242医院血液科,150066 [2]哈医大二院血研所,150086

出　　处：《航空航天医药》2004年第4期195-198,共4页Aerospace Medicine

摘　　要：目的 :观察亚砷酸注射液隔日静注治疗急性早幼粒细胞白血病的疗效。方法 :急性早幼粒细胞白血病 10例以亚砷酸 10mg稀释于 0 .85 %的生理盐水 2 5 0ml～ 5 0 0ml中 ,隔日一次静脉滴注 ,观察临床变化 ,并用原子荧光法测血砷浓度。结果 :坚持治疗的 7例均获完全缓解 ,时间 (60± 10 )d ,用药总量 (2 85±5 8)mg ,初治的 5例CR时间 (5 5± 6)d用药总量 (2 5 6± 2 8)mg。治疗过程中血小板、血红蛋白的下降无显著性 ,而白细胞 (入院时减少的 5例 )短期内即显著升高 ,(14 .6± 4.7)d达最高 (3 6.8± 19.7)× 10 9/L ,后逐渐下降 ,于骨髓缓解后才最后达正常。骨髓早幼粒细胞在减少的同时出现胞浆颗粒缺乏 ,染色质凝集 ,而中幼粒细胞随之增多 ,骨髓于 (5 6.0± 8.7)d完全缓解 ,初治的 5例 (5 1± 5 )d缓解。出凝血异常在 (19± 4.8)d得到纠正。毒副作用很轻微。结论 :亚砷酸隔日静注治疗急性早幼粒细胞白血病疗效高 ,副作用少 ,耐受性好 ,用药量低 ,减轻了经济负担。Objective:To observe the effect of acute promyelocytic leukemia (APL) with intravenous arsenic trioxide once every two days.Methods:10 mg arsenic trioxidc were diluted with 250～500 ml 0.85% physiological saline. Ten cases of APL were treated by arsenic trioxide solution once every two days. Data of clinical were analysed. Concentration of arsenie in blood was determined by atomic flouorimetry.Results:7 cases of continual treatment obtained complete remission. Times of reatment were 60±10 days, total dose of arsenic trioxide were 285±58 mg. The complete remission time of 5 patients in first treatment were 55±6 days, total dose of arsenie trioxide were 256±28 mg. Blood platelet and hemoglobin were on significantly deereasing. But Leucocyte was significantly increasing first, it reached the highest(36.8±19.7×10 9/L) sfter 14.6±4.7 days and then decreased stey by step, it reached normal level until bone marrow obtaince complete remission. Promelocytie in bone marrow was decreasing combined with endochylema pellet deficiency, chromatin agglutination and myelocyte was increasing. Bone marrow reached complete remission after 56.0±8.7 days. It was 51±5 days for 5 cases in first treatment, Abonrmal bleeding and coagulation were corrected within 19±4.8 days. Side effects were mild. Conclusion: Arenic trioxide was effective、little dose and better telerance in the treatment of APL.

关 键 词：砷剂 急性早幼粒细胞白血病 治疗 血砷浓度 

分 类 号：R733.71[医药卫生—肿瘤]