治疗相关急性早幼粒细胞白血病患者的临床分析  

Clinical analysis of patients with therapy-related acute promyelocytic leukemia patients

作　　者：贡蓉 贺少龙[1] 王涛[1] 田卫伟[1] 高志林[1] 马梁明[1] 郑转珍[2] 江波 乔振华[2] Gong Rong;He Sha-olong;Wang Tao;Tian Weiwei;Gao Zhilin;Ma Liangming;Zheng Zhuanzhen;Jiang Bo;Qiao Zhenhua(Deparement of Hematology,Shanxi Academy of Medical Science,Shanxi Dayi Hospital,Taiyuan 030032,China)

机构地区：[1]山西医学科学院山西大医院血液科,太原030032 [2]山西医科大学第二医院血液科

出　　处：《山西医药杂志》2018年第11期1251-1254,共4页Shanxi Medical Journal

摘　　要：目的通过对96例原发性急性早幼粒细胞白血病(APL)以及19例治疗相关APL(t-APL)患者的临床特点、治疗、预后进行分析,以提升对t-APL的认识,提出安全有效的t-APL治疗方案。方法回顾性分析2002—2014年由山西大医院和山西医科大学第二医院血液科收治的96例原发性APL和19例治疗t-APL的一般资料、临床表现、实验室检查、治疗及预后,对所有患者通过电话、医院登记等方式进行随访。随访结束后,所得数据采用SPSS19.0统计软件进行处理,比较2组患者的完全缓解(CR)率、分子学缓解率、5年总生存率。结果t-APL占APL的17%,t-APL组与原发性APL组的CR率分别为89%和91%,分子学缓解分别为74%和78%,2组中各有7例(7%)和2例(11%)复发,差异均无统计学意义(P>0.05);2组的5年生存率分别为60%和86%,差异均有统计学意义(P<0.05)。结论 t-APL发生占一定比例,经全反式维甲酸(ATRA)联合亚砷酸(ATO)与化疗结合治疗后,其CR率、分子学缓解率与原发性APL相比差异无统计学意义,但其5年生存率明显低于原发性APL,说明t-APL和原发性APL有相似治疗反应,但t-APL患者面临的死亡风险更高。Objective The clinical characteristics,treatment and prognosis of 96 cases of primary acute promyelocytic leukemia（APL）and 19 cases of therapy-related APL（t-APL）were analyzed to raise the awareness of t-APL then proposing a safe and effective treatment options for t-APL.Methods A retrospective analysis of 96 cases of APL and 19 cases of t-APL received by the Shanxi Dayi Hospital and the Second Hospital of Shanxi Medical University were performed,including the general data,clinical manifestation,laboratory examination,treatment and prognosis.All patients were followed up by telephone,hospital registration.By the end of follow-up,the collected data were processed by statistical software SPSS19.0,then we compared the complete remission（CR）rate,molecular remission rate,5 year overall survival rate of the two groups.Results t-APL accounted for17% of APL,and CR rates of t-APL and APL group were 89%and 91%;molecular remission rate were 74%and78%,7 cases（7%）and 2 cases（11%）in each group relapsed,respectively and there were no significant differences（P〉0.05）;the 5-year survival rate of two groups were 60% and 86%,respectively and the differences were statistically significant（P〈0.05）.Conclusion t-APL has accounted for a certain proportion in APL,by ATRA combined with ATO in combination with chemotherapy treatment,the CR rate,molecular remission rate of the two groups had no significant difference,but the 5-year survival rate of t-APL patients was significantly lower than that of primary APL,indicating that t-APL patients have a higher risk of death.

关 键 词：肿瘤 继发原发性 白血病 早幼粒细胞 急性 

分 类 号：R733.71[医药卫生—肿瘤]