急性早幼粒细胞白血病亚砷酸治疗剂量与复发关系的初步研究  

Relationship between the Therapeutic Doseof Arsenic Trioxide and Relapse in Acute Promyelocytic Leukemia

作　　者：王怀宇[1] 张慧云[1] 刘湲 张欣欣[1] 龚莎 陈丽梅[1] 王梦昌[1] 习杰英[1] 刘心[1] WANG Huai-Yu;ZHANG Hui-Yun;LIU Yuan;ZHANG Xin-Xin;GONG Sha;CHEN Li-Mei;WANG Meng-Chang;XI Jie-Ying;LIU Xin(Department of Hematology, The First Affiliated Hospital of Xi＇ an Jiaotong University, Xi＇ an 710061, Shaanxi Province, China;Department of Hematology, The First People＇s Hospital of Yunlin, Yulin 719000, Shaanxi Province, China)

机构地区：[1]西安交通大学第一附属医院血液科,陕西西安710061 [2]陕西省榆林市第一人民医院血液内科,陕西榆林719000

出　　处：《中国实验血液学杂志》2018年第3期705-709,共5页Journal of Experimental Hematology

基　　金：国家自然科学基金(81541026);陕西省自然科学基金(2016JM8113);西安交通大学第一附属医院临床研究课题(XJTU1AHCR2014-012);西安交通大学第一附属医院临床研究课题(XJTU1AF2016LSL-017)

摘　　要：目的:探讨亚砷酸(ATO)的治疗剂量与急性早幼粒细胞白血病(APL)复发的相关性以及ATO的最佳剂量与疗程。方法:回顾分析西安交通大学第一附属医院及榆林市第一人民医院血液内科2008-2015年收治APL患者102例临床资料,比较复发组与持续缓解组的临床特征。通过统计治疗达2年时ATO的使用剂量,以指南推荐剂量作为分组标准,将患者分为ATO高剂量组和低剂量组以比较2组的复发率。采用ROC曲线分析ATO剂量的界值。结果:单因素分析发现,治疗2年时ATO的低剂量组及高剂量组的复发率分别为17.7%和2.5%(P<0.05);进一步多因素分析发现,治疗2年时ATO剂量>22.4 mg/kg为疾病复发的独立防止因素(OR=0.119,P<0.05)。ROC曲线结果显示,治疗达2年时ATO的剂量的界值为8.765 mg/kg,ATO剂量大于8.765 mg/kg组的复发率明显低于小于8.765 mg/kg组。结论:APL的复发与ATO的使用剂量相关,足量使用ATO可降低疾病的复发率。Objective： To analyze the correlation of ATO therapeutic dose with the relapse of patients with acute promyelocytic leukemia（ APL） and to investigate the optimal dose and courses of ATO.Methods： The clinical data of 102 patients with APL from January 2008 to June 2015 were analyzed retrospectively.The clinical characteristics of APL patients in relapsed group and maintained remission group were compared.According to ATO dose in 2 years recommended in chinese guideline as criteria of grouping,the patients were divided into ATO high and low dose groups,then the relapse rate in groups was compared.The cut-off value of ATO dose was analyzed by ROC curve.Results： Univariate analysis showed that the relapse rate in high ATO and low ATO groups on 2 year treatment was 2.5% and 17.7% respectively（ P〈0.05）; multiple variate analysis demonstrated that the ATO dose 〉22.4 mg/kg on 2 year treatment was independent preventive factor for the relapse of APL（ OR = 0.119,P〈0.05）.The ROC curve showed that the cut-off value of ATO dose on 2 year treatment was 8.765 mg/kg.The relapse rate of APL in group of ATO dose 8.765 mg/kg group was significantly lower than that in group of ATO dose 8.765 mg/kg.Conclusion： The relapse of APL relates with used ATO dose,sufficient use of ATO dose can decrease the relapse rate of APL.

关 键 词：急性早幼粒细胞白血病 疾病复发 亚砷酸 

分 类 号：R733.71[医药卫生—肿瘤]