急性早幼粒细胞白血病缓解后治疗方案的选择  

Selection of therapeutic methods in patients with acute promyelocytic leukemia after complete remission

作　　者：戴辉[1] 杨建民[2] 

机构地区：[1]宁波市医疗中心李惠利医院,浙江宁波315040 [2]第二军医大学附属长海医院,上海200082

出　　处：《现代实用医学》2005年第9期538-539,546,共3页Modern Practical Medicine

摘　　要：目的寻求一种有效的急性早幼粒细胞白血病(APL)缓解后的治疗方案。方法32例APL患者经全反式维甲酸(ATRA)诱导分化达完全缓解后,14例采用ATRA、联合化疗交替治疗,18例采用ATRP、联合化疗及As2O3序贯治疗,分析两种治疗方案的疗效、不良反应及对PML/RARα融合基因的影响。结果序贯组、交替组3年累计CCR率分别为87.3%和52.6%,两组PML/RARα融合基因阳性率同期比较差异无显著性;联用As2O3序贯治疗不良反应轻微。结论APL患者CR后,采用ATRA、联合化疗及As2O3序贯治疗,持续缓解率高,不良反应轻微。Objective To explore an effective remedy for patients with acute promyelocytic leukemia （APL） after complete remission. Methods Thirty-two patients with APL induced to complete remission by all-trans retinoic acid （ATRA） were divided into two groups. Fourteen patients in group A were treated with alternate therapy of ATRA and combinative chemotherapy. Eighteen cases in group B were treated with sequential therapy of arsenic trioxide combined with ATRA and combinative chemotherapy. Clinical effects, side effects and PML/ RARer mRNA were analysed in two groups. Results The three-year continual complete remission （CCR） rate was 87.3% for group B; 52.6% for group A; the significant differences were found between the two groups. No significant differences in the positive rate of PML/RARα mRNA were observed between the two groups at every time. The side effects of sequential therapy were mild. Conclusion For patients with APL after CR, sequential therapy combinding ATRA, chemotherapy and arsenic trioxide can obtain a higher CCR rate without intolerable side effects.

关 键 词：急性早幼粒细胞白血病 砷剂 维甲酸 化学疗法 辅助 

分 类 号：R733.71[医药卫生—肿瘤]