全反式维甲酸联合三氧化二砷与全反式维甲酸单独治疗急性早幼粒细胞白血病疗效比较的Meta分析  

Meta-analysis of the effectiveness of all-trans retinoic acid with and without arsenic trioxide in the treatment of acute promyelocytic leukemia

作　　者：刘亚杰[1] 马晓波[2] 邱旭[3] 殷华[2] 王国立[2] 

机构地区：[1]河北联合大学冀唐学院图书馆.河北唐山063000 [2]河北联合大学附属医院 [3]河北联合大学图书馆

出　　处：《现代预防医学》2013年第22期4119-4123,4130,共6页Modern Preventive Medicine

摘　　要：目的评价全反式维甲酸(all-trans retinoic acid,ATRA)联合三氧化二砷(arsenic trioxide,ATO)治疗急性早幼粒细胞白血病(acute promyelocytic leukemua,APL)的疗效。方法采用Meta分析方法,对近10年国内外有关比较ATRA联合ATO治疗与ATRA单独治疗APL疗效的随机对照试验文献(RCT),提取完全缓解率(CR)、复发率、病死率结局评价指标进行定量综合分析,估计合并OR值及其95%可信区间(95%CI)。结果共纳入6项RCT,共包括317例APL患者。Meta分析结果显示,ATRA联合ATO与ATRA单用治疗APL比较,CR、复发率差异有统计学意义,病死率结局指标差异无统计学意义(P﹥0.05),以上各结局指标的OR及其95%CI分别为2.24[1.22,4.14]、0.19[0.08,0.45]和0.41[0.15,1.14]。结论采用ATRA联合ATO治疗与ATRA单药治疗APL可提高CR,降低复发率。OBJECTIVE The objective of the study was to evaluate the effectiveness of combining all-trans retinoic acid （A- TRA） with arsenic trioxide （ATO） in the treatment of acute promyelocytic leukemia （APL）. METHODS Meta-analysis was adopted in this study. Outcome indicators, such as complete remission （CR） rate, recurrence rate, and mortality rate, were extracted from domestic and foreign literatures on comparing the effectiveness of ATRA with or without ATO on the treatment of APL by randomized controlled trials （RCTs） published in the recent decade, and were quantitatively analyzed. Combined OR values and the 95% confidence intervals （95% Cls） were estimated. RESULTS 6 RCTs and 317 APL patients were in- cluded. Results of the meta-analysis indicated that the difference in CR and recurrence rate between ATRA/ATO combinatori- al treatment and ATRA monotherapy was statistically significant, and that no significant difference in mortality rate was ob- served between the two treatments （P 〉 0.05）. OR of the abovementioned outcome indicators and the 95% CI were 2.24 [1.22, 4.14], 0.19 [0.08, 0.45], and 0.41 [0.15, 1.14], respectively. CONCLUSION ATRA/ATO combinatorial treatment can improve CR and reduce recurrence rate of APL.

关 键 词：全反式维甲酸 三氧化二砷 急性早幼粒细胞白血病 联合 

分 类 号：R733.71[医药卫生—肿瘤]