不同方案诱导治疗儿童急性早幼粒细胞白血病的临床分析  

Different induction therapies in the treatment of childhood acute promyelocytic leukemia

作　　者：王静[1] 贾月萍[1] 刘桂兰[1] 陆爱东[1] 张乐萍[1] 左英熹[1] 王彬[1] 

机构地区：[1]北京大学人民医院,北京100044

出　　处：《临床儿科杂志》2014年第5期405-409,共5页Journal of Clinical Pediatrics

摘　　要：目的比较全反式维甲酸(ATRA)和三氧化二砷(As2O3)联合与不联合蒽环类药物诱导治疗儿童急性早幼粒细胞白血病(APL)的疗效和不良反应。方法回顾性分析2002年1月1日至2012年12月31日初治的46例APL患儿的临床资料,并根据不同诱导化疗方案和初始白细胞高低进行分组和对比分析。结果 30例不加蒽环组患儿中有2例早期死亡,而16例加蒽环组患儿无一早期死亡。加蒽环组与不加蒽环组的完全缓解率、达分子学缓解时间和诱导化疗结束时微小残留病定量分析的差异均无统计学意义(P>0.05)。加蒽环组的高白细胞持续时间明显短于不加蒽环组,差异有统计学意义(P<0.05)。全体加蒽环组和不加蒽环组的凝血异常时间、肝脏毒性、感染率差异无统计学意义(P均>0.05)。结论儿童APL诱导化疗中联合蒽环类药物可减少高白细胞持续时间,降低白细胞峰值,有助于减少早期死亡。Objectives To compare the efficacy and adverse effects of combining all-trans retinoic acid and arsenic triox-ide with or without anthracyclines on the treatment of childhood acute promyelocytic leukemia （APL） patients. Methods The retrospective study included 46 children as newly diagnosed APL from January 1st, 2001 to December 31st , 2012. Efficacy and adverse effects for different induction therapies and in high and low white blood cell （WBC） count subgroups were studied. Results In the non antharcycline containing group, 2 patients died during remission induction, and in the antharcycline containing group none of the patients died. No statistical difference was observed between the antharcycline containing group and the non antharcycline containing group in complete remission, the length of time to achieve molecular complete remission and minimal residual disease quantitative analysis at the end of the induction. The mean duration of high WBC count subgroup in the anthar-cycline containing group was shortened than that of the non antharcycline containing group （P〈0.05）. The recovery time of the abnormal coagulation was found similar between these two groups. Conclusions The use of antharcycline in induction therapy could shorten the duration of high WBC count and reduced the WBC count peak , thus reduces the risk of early death.

关 键 词：急性早幼粒细胞白血病 蒽环类 诱导治疗 临床分析 儿童 

分 类 号：R733.71[医药卫生—肿瘤]