上海地区1083例成人急性粒细胞性白血病初治缓解率的观察  

Current status of complete remission rate of 1083 adults with acute myeloid leukemia in Shanghai

作　　者：王小钦 林果为 王军 林佩娣 王倩 

机构地区：[1]上海市白血病协作组,200040

出　　处：《上海医学》2002年第3期142-145,共4页Shanghai Medical Journal

摘　　要：目的　总结成人急性粒细胞性白血病 (AML)的疗效及影响因素。方法　对上海地区 10 83例成人初发急性粒细胞性白血病进行回顾性临床分析。结果　成人急性粒细胞性白血病完全缓解 (CR)率为 5 5 .5 % ,M3 的CR率最高 ,为 71.1% ,M5的CR率最低 ,为 42 .5 %。 1984～ 1994年除外M3 亚型的AML的各年CR率停留在 40 %～ 6 0 % ,无明显提高。 1984～ 1988年M3 的CR率为 5 5 .9% ,而 1989～ 1994年CR率为 84.9% (P <0 .0 1) ,同期诱导缓解死亡率分别为 2 2 .1%和 7.9%。M3 的CR率提高与全反式维甲酸的应用密切相关 ,用维甲酸和用其他方案诱导缓解的CR率分别为 86 .4%和 5 7.5 % (P <0 .0 1)。常规剂量和较大剂量诱导缓解化疗CR率分别为 5 5 .1%和 5 7.8% (P =0 .6 7)。DA、HOAP和HA方案的CR率无差异。结论　 1984～ 1994年AML(除外M 3)CR率无明显提高。维甲酸的应用明显提高M3 的CR率 ,降低诱导缓解死亡率。Objective To summarize the effectiveness of treatment in adults with newly diagnosed acute myeloid leukemia(AML). Methods One thousand and eighty three adults with AML registered in Shanghai were retrospectively analyzed. Results The overall CR rate was 55.5%. The CR rate of acute promyelocytic leukemia(M 3) was the highest(71.1%), and that of acute monocytic leukemia was lowest(42.5%). The CR rate of AML(except M 3) remained standstill below 60% between 1984 and 1994. The CR rate of M3 was only 55.9% in that period (1984~1988), while it increased to 84.9% in 1989～1994( P <0.01).Meanwhile, the induction related mortality of M 3 had decreased from 22.1% to 7.9%. The use of all transretinoic acid(ATRA) for M 3 had led to an increase of CR rate from 57.5% to 86.4%( P <0.01), and a decrease in the induction related mortality from 22% to 4%( P < 0.01). The CR rate by standard dose compared with that by high dose chemotherapy was 55.1% versus 57.8%( P =0.67). Conclusion In a non selected data of AML(except M 3) adults, the CR rate was not improved despite the use of high dose chemotherapy ( 1984～1994),and that use of ATRA as a first line therapy improved markedly the CR rate of M3.

关 键 词：急性粒细胞性白血病 药物治疗 初治缓解率 

分 类 号：R733.7[医药卫生—肿瘤]