全反式维甲酸、四硫化四砷、化疗三联方案在急性早幼粒细胞白血病维持治疗中的应用  

Application of all.trans retinoic acid combining chemotherapy and As4S4 in the maintenance treatment of patients with acute promyelocytic leukemia

作　　者：林全德[1] 魏旭东[1] 汪萍[1] 刘艳艳[1] 张丽娜[1] 李玉富[1] 高全立[1] 朱兴虎[1] 张莉 房佰俊[1] 岳寒[1] 杜建伟[1] 蒋冬霞[1] 胡杰英[1] 宋永平[1] 

机构地区：[1]河南省肿瘤医院血液科、河南省血液病研究所,郑州450008

出　　处：《中华血液学杂志》2007年第1期19-21,共3页Chinese Journal of Hematology

摘　　要：目的比较全反式维甲酸（ATRA）、四硫化四砷（As4S4）、化疗三联方案与ATRA、化疗二联方案在急性早幼粒细胞白血病（APL）维持治疗中的疗效差异。方法60例APL患者经ATRA诱导分化达完全缓解（CR）后，用联合化疗巩固治疗。随后随机分为两组，三联组30例用ATRA＋As4S4＋化疗维持治疗，二联组30例仅应用ATRA＋化疗维持治疗。分析两种治疗方案的疗效、不良反应及对PML-RARα融合基因转阴的影响。结果三联组3年累计持续完全缓解（CCR）率为90．0％，二联组为63．3％，三联组PML—RARα融合基因转阴率明显高于二联组（分别为90％和63％，P〈0．05）。加用As4S4治疗不良反应未明显加重。结论APLCR患者巩固治疗后应用ATRA＋As4S4加化疗维持治疗，CCR率高，不良反应轻。Objective To compare the efficacy of all-trans retinoic acid （ATRA）combining chemotherapy and As4S4 with ATRA combining chemotherapy for the maintenance treatment of patients with acute promyelocytic leukemia （APL）. Methods Sixty patients with APL induced to complete remission by ATRA and consolidated by chemotherapy were randomly divided into two groups. Thirty patients as As4S4 group received ATRA ＋ As4S4 ＋ chemotherapy, and another thirty patients as non- As4S4 group were treated only with ATRA ＋ chemotherapy as maintenance therapy. The therapeutic effects, side effects and PML-RARα gene expression were analyzed. Results The three-year continuous complete remission （CCR） rate was 90.0% for As4S4 group and 61.1% for non-As4S4 group, the difference being statistically significant. Significant difference was also found in the positive rate of PML-RARα fusion gene between the two groups. The side effects were mild. Conclusion APL patients in maintenance therapy with ATRA ＋ 6-MP ＋ MTX ＋ As4S4 can obtain a higher CCR.

关 键 词：白血病 早幼粒细胞 急性 维甲酸 砷剂 治疗结果 

分 类 号：R686[医药卫生—骨科学]