急性早幼粒细胞白血病合并出血的临床分析  

CLINIC STUDY ABOUT EARLY HEMORRHAGIC SYMPTOMS IN ACUTE PROMYELOCYTIC LEUKEMIA

作　　者：许贞书[1] 战榕[1] 付丹晖[1] 陈志哲[1] 黄淑桦[1] 

机构地区：[1]福建医科大学附属协和医院,福建福州350001

出　　处：《白血病．淋巴瘤》2002年第3期143-145,共3页Journal of Leukemia & Lymphoma

摘　　要：目的 :研究急性早幼粒细胞白血病 (APL)合并出血的临床特征和全反式维甲酸(ATRA)对 APL 早期出血的影响。方法 :回顾性总结 110例 APL 患者的临床特点和实验室检查结果 ;并比较 ATRA治疗与传统化疗的疗效。结果 :110例患者合并出血 5 6例 (5 0 .9% ) ,早期出血死亡12例 (10 .9% )。早期出血死亡的危险因素有 :高白血病细胞 (>1× 10 9/ L) ,低血小板 (<30× 10 9/ L) ,低纤维蛋白原 (<1.5 g/ L) ,高龄 (>5 0岁 ) ,血红蛋白 (<10 g/ L)。ATRA治疗组早期出血死亡率 ,血小板 <30× 10 9/ L、纤维蛋白原 <1.0 g/ L 的时间 ,以及输注血制品次数均明显减少。结论 :APL 出血发生率较高 ;ATRA治疗明显减少早期出血死亡率 ,提高了 APLObjective:To explore the clinical features,as well as responses during induction therapy with all trans retinoic acid (ATRA),of hemorrhagic symptoms in acute promyelocytic leukemia (APL).Methods:The clinical features and laboratory findings of 110 cases APL were analyzed respectively.Then we conducted the comparion between ATRA and conventional chemotherapeutic regimens during induction therapy.Results:Fifty six (50.9 %) hemorrhage episodes,including 12(10.9 %) early hemorrhagic deaths (EHDs) were observed.The risk factors of hemorrhage were blast count (>1×10 9/L),platelet count (<30×10 9/L),fibrinogen (<1.5 g/L),age (>50 years old) as well as hemoglobin (<10 g/L).There were significantly less EHDs,the days with low platelet count or fibrinogen as well as the number of transfusions in the ATRA group.Conclusion:There was a high rate of hemorrhage in APL.Administration of ATRA reduced the incidence of EHD and led to an improvement of complete remission (CR) rate.

关 键 词：急性白血病 早幼粒细胞 早期死亡 出血 全反式维甲酸 

分 类 号：R733.7[医药卫生—肿瘤]