急性早幼粒细胞白血病缓解后治疗方案的疗效分析  

Analysis of long-term outcome of patients with acute promyelocytic leukemia treated with different regimens after complete remission

作　　者：郭明[1] 薛华[1] 化罗明[1] 郝淑香[1] 韩颖[1] 王四宝[1] 

机构地区：[1]河北大学附属医院血液科,保定071000

出　　处：《肿瘤》2008年第2期150-152,共3页Tumor

基　　金：河北省科技攻关计划资助项目(编号:072761435)

摘　　要：目的:探索更有效的急性早幼粒细胞白血病(acute promyelocyte leukemia,APL)缓解后的治疗方案。方法:初治APL患者应用全反式维甲酸(all-trans retinoic acid,ATRA)诱导分化,达到完全缓解(complete response,CR)的50例患者分为2组,采取不同的缓解后治疗方案:复方黄黛片和化疗交替组(A组,23例);ATRA和化疗交替组(B组,27例),比较2种缓解后治疗方案的远期疗效。结果:50例患者中复发8例,A组1/23例(4.3%),B组7/27例(25.9%),差异有统计学意义(P=0.038)。远期疗效A组明显优于B组(3年无病生存率分别为100%和79%,5年无病生存率分别为91%和58%,P=0.023)。结论:复方黄黛片与化疗交替为一种理想的APL缓解后治疗方案,疗效优于ATRA与化疗交替组。Objective：To explore a more effective treatment regimen for patients with acute promyelocytic leukemia （APL） after complete remission （CR）. Methods：Fifty patients with newly diagnosed APL were induced to CR by all-trans retinoic acid （ATRA）. They were divided into two groups. Twenty-three patients in group A were given with alternative therapy with compound realgar and natural indigo tablet （CRNIT） and combined chemotherapy. Twenty-seven patients in group B were treated with alternative therapy with ATRA and combined chemotherapy. Long-term clinical outcomes were compared between the two groups. Results： Eight of the total 50 patients relapsed. The relapse rates in group A and group B were 4.3% and 25.9%, respectively. The difference was significant （P=0.038）. The three-year and five-year disease-free survival （DFS） rate of group A was markedly superior than group B （100% and 91% vs 79% and 58%; P=0.023）. Conclusion： Alternative therapy with CRNIT and combined chemotherapy for APL patients after CR was more effective than that of ATRA and combined chemotherapy.

关 键 词：白血病 早幼粒细胞 急性 缓解后治疗 预后 

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