全反式维甲酸与三氧化二砷对急性早幼粒细胞白血病的疗效评价  

Systematic review of all- trans retinoic acid and arsenic trioxide in treating acute promyelocytic leukemia

作　　者：陈月[1] 徐雅晶[1] 黄婧[1] 冯婉玉[1] 

机构地区：[1]北京大学人民医院药剂科,北京100044

出　　处：《中国临床药理学杂志》2014年第2期118-121,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的 评价全反式维甲酸（ATRA）、三氧化二砷（ATO）单药及联合使用治疗急性早幼粒细胞白血病（APL）的临床疗效及不良反应.方法 用Cochrane系统评价方法,检索CNKI、VIP、CBM、PubMed、EMBase、the Cochrane library数据库（2000~2013年）,收集ATRA、ATO单药与联合应用治疗APL的随机对照研究,用RevMan 5.0软件对相关数据进行Meta分析.结果 ATRA＋ATO和ATRA组比较,ATRA＋ATO组完全缓解率优于ATRA单药治疗,达到完全缓解的时间短,差异均有统计学意义（P＆lt;0.05）.ATRA＋ATO和ATO单药组比较,完全缓解率差异无统计学意义（P＆gt;0.05）,达到完全缓解的时间差异有统计学意义（P＆lt;0.05）.早期死亡人数差异均无统计学意义（P＆gt;0.05）.不良反应除头痛肌肉痛外,其他差异无统计学意义.结论 ATRA＋ATO组治疗APL疗效优于单用ATRA,与单用ATO比较差异无统计学意义,完全缓解的时间联用组优于单药组.Objective To evaluate the clinical efficacy and adverse reactions of using all - trans retinoic acid （ATRA） and arsenic trioxide （ATO） alone or combination in treating acute promyelocytic leukemia （APL）. Methods The published articles about all -trans retinoic acid and arsenic trioxide in treating acute promyelocytic leukemia were collected from CNKI, VIP, CBM, PubMed, EMBase and the Cochrane library database. The data were analyzed and the forest plot with meta analysis was drawn by RevMan 5.0. software. Results The treatment of ATRA combined with ATO was superior to ATRA in complete remission rate （P 〈 0. 05 ）, the time to complete remission rate has the statistical differ- ence （ P 〈 0. 05 ）, early casualty non - statistical difference （ P 〉 0. 05 ）. The complete remission rate had no significant difference between the AT- RA combined with ATO treatment group and ATO treatment group, there was no significant difference in complete remission rate （ P 〉 0. 05 ）, the time to complete remission rate has the statistical difference （ P 〈 0. 05 ）, There were no significant difference in the incidence of adverse drug reac- tion except muscle pain and headache. Conclusion The effect of AT- RAcombined with ATO is better than ATRA single treatment on both the complete remission rate and the time to complete remission of acute promyelocytic leukemia patients. Compared with ATO single therapy, thecombined treatment does not show advantage in the complete remission rate, while has shorter time achieving complete remission.

关 键 词：全反式维甲酸 三氧化二砷 急性早幼粒细胞白血病 META分析 

分 类 号：R733.73[医药卫生—肿瘤]