全反式维甲酸联合三氧化二砷治疗急性早幼粒细胞白血病的疗效观察  

Efficacy observation of the combination of all-trans retinoic acid with arsenic trioxide on patients of acute promyelocytic leukemia

作　　者：朱喜丹[1] 陈梅[2] 冯林[2] 田刚[1] 

机构地区：[1]泸州医学院附属医院检验科,四川泸州646000 [2]泸州医学院附属医院血液科,四川泸州646000

出　　处：《国际检验医学杂志》2013年第3期309-310,312,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨全反式维甲酸(ATRA)联合三氧化二砷(ATO)治疗早幼粒细胞白血病(APL)的疗效。方法对35例APL患者应用ATRA联合ATO治疗,观察PML-RARα融合基因转阴率、达到血液学完全缓解(CR)所需时间和不良反应情况,并与18例单独使用ATO和19例单独使用ATRA患者的上述指标进行比较。结果联合用药患者PML-RARα融合基因转阴率为94.3%,单独使用ATO患者转阴率为88.9%,单独使用ATRA患者转阴率为94.7%,三者比较差异无统计学意义(P>0.05);联合用药组达到CR时间为(24.2±5.7)d,ATO组为(36.0±7.1d),ATRA组为(40.9±8.5)d,三者比较差异有统计学意义(P<0.05);3组比较,联合用药患者转氨酶升高(P<0.05),ATO组心肌损伤标志物升高(P<0.05),ATRA组血脂高(P<0.05)。结论 ATRA联合ATO治疗APL完全缓解率高,所需时间短,对血脂和心脏影响较小,但肝脏毒性较大。Objective To investigate the therapeutic efficacy of all-trans retinoic acid（ATRA） combined with arsenic trioxide （ATO）on patients with acute promyelocytic leukemia（APL）. Methods The therapeutic effect of 35 APL patients with ATRA and ATO therapy（combination group） was compared with that of 18 patients treated with ATO alone（ATO group） and 19 patients treated with ATRA alone（ATRA group）. PML-RARα negative conversion rate,period to complete remission（CR） and side effect were observed in 3 groups. Results The PML-RARα fusion gene negative conversion rates of combination group, ATO group and ATRA group were 94.3 %, 88.9 % and 94.7 %, respectively. There was no significantly difference in 3 groups（P〉0.05）. The pe- riods to CR of combination group, ATO group and ATRA group were （24.2±5.7） ,（36.0±7.1） and （40.9±8.5） d, respective- ly. The combination group had the shortest period to CR than other two groups（P〈0.05）. Comparing among 3 groups, the values of ALT and AST increased in combination group（P〈0.05） , the values of myocardial injury markers increased in ATO group（P〈 0.05） ,and the values of TG increased in ATRA group（P〈0.05）. Conclusion Combination of ATRA with ATO treatment could increase PML-RARα negative conversion rate and shorten the period to CR, with less affection to cardiac and blood lipid, however its hepatotoxicity should be noted.

关 键 词：全反式维甲酸 三氧化二砷 急性早幼粒细胞白血病 

分 类 号：R733.7[医药卫生—肿瘤]