维甲酸治疗急性早幼粒细胞白血病出现的白细胞增多症及其处理  

HYPERLEUKOCYTOSIS IN ALL-TRANS RETINOICACID TREATED ACUTE PROMYELOCYTIC LEUKEMIAAND ITS MANAGEMENT

作　　者：邓星明[1] 王德炳[1] 傅剑锋 丘镜滢[1] 单福香 卢锡京[1] 江滨[1] 史琪 刘亚平 张秀莲 李小妹 陆道培[1] 

机构地区：[1]北京医科大学人民医院血液病研究所

出　　处：《中华血液学杂志》1995年第7期341-343,共3页Chinese Journal of Hematology

摘　　要：作者用全反式维甲酸（ＡＴＲＡ）治疗５５例急性早幼粒细胞白血病（ＡＰＬ），１４例出现白细胞增多症，发生率为２５．４％，其中外周血白细胞高限在２０×１０￣９／Ｌ～５０×１０￣９／Ｌ之间５例，单用ＡＴＲＡ治疗，４例获完全缓解（８０％）；白细胞高限大于５０×１０￣９／Ｌ９例，采用ＡＴＲＡ与三尖杉酯碱或羟基脲联合化疗，８例获完全缓解（８８．９％）。另外，在９例白细胞高限大于５０×１０￣９／Ｌ的病例中，５例出现白细胞滞留综合征，经治疗后４例滞留症状消失。表明ＡＴＲＡ与化疗相结合，对ＡＴＲＡ治疗期间出现的白细胞增多症是一种有效的措施，可以减低早期死亡率。ifty-five patients with acute promyelocytic leukemia(APL) were treated with all-trans retinoic acid (A-TRA). Out of these patients , 14 (25. 4%) developedhyperleukocytosis . Five patients with the highestwhite cell counts between 20 ×10￣9/L and 50×10￣9/Lcontinued with only ATRA therapy, and four (80%)obtained complete remission . Nine patients with thehighest white cell counts> 50 ×10￣9/L were treatedwith harringtonine or hydroxyurea in addition to A-TRA and CR was achieved in eight (88. 9%). Mean-while , five of nine patients with the highest white cellcounts>50×10￣9/L developed leukostasis syndrome ,and the syndrome subsided in four after treatment.The results indicated that ATRA/cytotoxic drug com-bination therapy seemed to be an effective modality forthe treatment of hyperleukocytosis during ATRA ther-apy for APL.

关 键 词：急性 早幼粒细胞 白血病 维甲酸 白细胞增多 

分 类 号：R733.710.5[医药卫生—肿瘤] R979.1[医药卫生—临床医学]