不同方案治疗急性早幼粒细胞白血病近期和远期疗效观察  

Short-term and long-term efficacy analysis of different treatment on acute promyelocytic leukemia patients

作　　者：景莉[1] 王秦[2] 袁凯锋[1] 吴鹏强[1] 李晓明[1] 

机构地区：[1]泸州医学院附属医院血液内科,四川泸州646000 [2]泸州医学院附属医院药剂科,四川泸州646000

出　　处：《中国医学前沿杂志（电子版）》2015年第8期48-51,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的评价不同方案治疗急性早幼粒细胞白血病(acute promyelocytic leukemia,APL)的近期及远期疗效。方法回顾本院2004年1月至2010年1月收治的200例APL患者,按照不同诱导缓解治疗方案分为化疗组、维A酸组和三氧化二砷(arsenic trioxide,ATO)组。通过比较三组患者完全缓解(complete remission,CR)率以及获得CR所需时间、不良反应发生率等,评价三种治疗方案的近期疗效。通过比较三组患者5年总生存率、复发率,评价三种治疗方案的远期疗效。结果维A酸组与ATO组患者CR均优于化疗组(P<0.05),患者获得CR所需时间均短于化疗组(P<0.05)。化疗组患者普遍出现口干头痛,部分患者存在骨髓抑制、皮疹等不良反应;维A酸组患者不良反应以高白细胞血症为主,同时出现维A酸综合征;ATO组患者出现肝功能异常、转氨酶升高。化疗组患者复发率高于维A酸组和ATO组(P<0.05),5年总生存率低于维A酸组和ATO组(P<0.05),维A酸组与ATO组比较并无显著差异(P>0.05)。结论维A酸联合化疗药物或ATO均能够获得较好的远期及近期疗效。Objective To investigate the short-term and long-term efficacy of different treatment on the patients with acute promyelocytic leukemia(APL). Method 200 cases of patients from January 2004 to January 2010 in our hospital were divided into chemotherapy group, tretinoin group and arsenic trioxide(ATO) group. By comparing the rate of complete remission(CR) and obtain the CR required time, incidence of adverse reactions to evaluated the short-term and long-term follow-up results of three treatment regimens. Result CR rate of patients in tretinoin group and ATO group were lower than chemotherapy group and the time of treatment were shorter than chemotherapy group. The main adverse reactions of tretinoin group were high blood leukocytes, followed by retinoic acid syndrome, and the main adverse reactions of ATO group were abnormal liver function and transaminase lifts. The recurrence rate of patients in chemotherapy group were higher than tretinoin group and ATO group(P < 0.05), 5 years survival rate was lower than tretinoin group and ATO group(P < 0.05), but there was no significant difference between tretinoin group and ATO group(P > 0.05). Conclusion Tretinoin combined with chemotherapeutics or ATO can obtain better long-term and short-term follow-up results.

关 键 词：急性早幼粒细胞白血病 维A酸 三氧化二砷 

分 类 号：R733.71[医药卫生—肿瘤]