三氧化二砷联合阿糖胞苷诱导急性早幼粒白血病疗效分析  

Arsenic trioxide joint cytarabine induced acute promyelocytic leukemia curative effect analysis

作　　者：葛繁梅[1] 任羽[1] 苏保雄[1] 刘卉[1] 刘宇宏[1] 曹慧琴[1] 王红娟[1] 

机构地区：[1]延安大学附属医院血液免疫科,陕西延安716000

出　　处：《延安大学学报（医学科学版）》2013年第4期9-12,共4页Journal of Yan'an University:Medical Science Edition

摘　　要：目的 探讨三氧化二砷（arsenic trioxide,ATO）联合阿糖胞苷和全反式维甲酸（all-trans retinoic acid,AT-RA）联合化疗治疗初治和复发急性早幼粒细胞白血病（acute promyelocyticleukemia.APL）的缓解率和安全性.方法 回顾分析初治和复发急性早幼粒细胞白血病52例,分为ATO组28例和ATRA组24例,对比两组完全缓解率（CR）和副作用.结果 52例初治和复发APL患者诱导治疗一个疗程后,ATO组和ATRA组CR率分别为92.8％和70.8％;ATO组死亡2例,ATRA组死亡4例;比较两组CR差异有统计学意义（P＜0.005）.ATO组患者达到CR的中位时间为28.6 d（28～33 d）,明显短于ATRA组患者的37 d（29～50 d）（P＜0.001）.50％的ATRA组患者出现维甲酸综合征.外周血白细胞数和治疗过程中白细胞峰值与维甲酸综合征的发生几率呈正相关.结论 三氧化二砷联合阿糖胞苷诱导APL达CR的时间短于ATRA组,缓解率高于ATRA组,副作用小,早期死亡率低.Objective To discuss arsenic trioxide combine cytarabine and all - trans retinoic acid with combination chemotherapy treatment early treated and recurrence of acute promyelocytic leukemia remission rate and safety. Methods Retrospective analysis the early cure and recurrence of acute myelocytic leukemia 52 cases, divide into ATO group 28 cases and ATRA group of 24 cases,compared two groups of complete response rate （CR） and side effects. Results 52 cases of cure and recurrence in patients with APL at the beginning of a period of treatment of CR, The CR of ATO and ATRA group were 92.8% and 70.8% respectively;ATO group 2 cases died, ATRA group died 4 cases ; Compare two groups of CR difference was statistically significant （ P 〈 0. 005 ）. ATO group of patients achieve CR in a time of 28.6 d （28 -33 d） , significantly shorter than ATRA group of patients with 37 d （29 -50 d） （P 〈0. 001）. There were 50% of retinoic acid syndrome in patients with ATRA group. Conclusion： Arsenic trioxide joint cytarabine induction APL for CR group was shorter than ATRA, remission rate higher than that of ATRA group, side effect is small, early mortality is low.

关 键 词：急性早幼粒细胞白血病 三氧化二砷 阿糖胞苷 

分 类 号：R733.7[医药卫生—肿瘤]