AIDA方案治疗急性早幼粒细胞白血病分子生物学疗效初步观察  

Clinical evaluation of molecular remission in acute promyelocytic leukemia by AIDA (All-trans Retinoic+Indarubicin+Cytarabine) regimen

作　　者：丁汀[1] 曾晓颖[1] 陈莉莉[1] 李军民[1] 陈钰[1] 赵维莅[1] 曹琪[1] 沈志祥[1] 

机构地区：[1]第二医科大学附属瑞金医院血液科

出　　处：《临床血液学杂志》2001年第6期243-244,246,共3页Journal of Clinical Hematology

摘　　要：目的 :观察全反式维甲酸加去甲氧柔红霉素加阿糖胞苷 (AIDA)方案治疗急性早幼粒细胞白血病(APL)患者的分子生物学疗效。方法 :在全反式维甲酸 (ATRA)诱导缓解后的 32例APL患者中 ,予去甲氧柔红霉素 (IDA)加阿糖胞苷巩固化疗 2个疗程 ,治疗前后检测PML/RARα融合基因水平。结果 :临床和血液学完全缓解 2 9例 (91% ) ,部分缓解 2例 (6 % ) ,总有效率 97%。分子生物学缓解率达 31% ,10例转阴者随访 1年内连续2次检测基因持续阴性者 3例 (30 % )。结论 :AIDA方案是治疗APL达到分子生物学缓解的有效方法 ;年龄、治疗前白细胞数、ATRA诱导缓解时间及IDA应用的疗程和剂量 。Objective:To study the clinical and molecular efficiency in patients with Acute Promyelocytic Leukemia (APL) by combined All-trans Retinoic Acid and indarubicin?cytarabine(AIDA) therapy.Method:Thirty-two patients with APL after induction treatment consisted of oral All-trans Retionoic Acid (ATRA) until complete remission (CR) were eligible to give intravenous. Indarubicin and Cytarabine. Two cycleB s of Ida+Ara-c consolidation. Molecular response by RT-PCR was assessed.Result:Clinical CR was obtained in 29 cases (91%), PR 2 cases (6%), the total response rate was 97% in the first year group. RT-PCR negative were obtained in 10 cases (31%), 1 with the first consolidation and 9 with the second consolidation, no one after induction treatment. 3 cases were in sustained molecular remission of RT-PCR; Comparing the PCR-positive group, the ages in patients with PCR -negative group were younger, the white blood cell count in peripheral blood before therapy was lower, DFS was shorter (P< 0.05 ); the overall survival was similar, but the event-free survival of PCR-negative group was longer(P< 0.05 ).Conclusion:This responses of AIDA was effective. The age, white blood cell count, sensitivity to regiment of ATRA, Ida and Ara-c are important factors which could influent the RT-PCR negative.

关 键 词：急性早幼粒细胞白血病 去甲氧柔红霉素 PML/RARΑ融合基因 AIDA方案 

分 类 号：R733.710.5[医药卫生—肿瘤]