三氧化二砷联合全反式维甲酸治疗急性早幼粒细胞白血病的临床研究  

Clinical study on arsenic trioxide combined with all-trans rtinoic acid in the treatment of acute promyelocytic leukemia

作　　者：张慧琪[1] 杨宇佳 ZHANG Huiqi;YANG Yujia(Department of Hematology,Huzhou First People＇s Hospital in Zhejiang Province,Huzhou 313000,China)

机构地区：[1]浙江省湖州市第一人民医院血液科,浙江湖州313000

出　　处：《中国现代医生》2018年第25期105-108,共4页China Modern Doctor

基　　金：浙江省湖州市科技计划公益性应用研究项目(2017GYB04)

摘　　要：目的探讨急性早幼粒细胞白血病患者采用三氧化二砷联合全反式维甲酸治疗的效果。方法选取本院2012年10月～2014年10月收治的急性早幼粒细胞白血病患者60例,根据随机数表法分为两组,各30例。对照组患者单纯接受化疗治疗,并将化疗治疗与全反式维甲酸交替实施;观察组患者则在对照组基础上联合使用三氧化二砷。对比两组患者治疗完全缓解率、早期死亡率、复发率及第1年、第2年、第3年的总生存率,同时记录两组患者在接受药物治疗期间发生的头痛、轻度皮肤黏膜干燥、消化道症状、心肌缺血等不良反应。结果两组患者早期死亡率比较,差异无统计学意义(P>0.05);观察组完全缓解率高于对照组,复发率低于对照组,平均完全缓解时间较对照组短,差异有统计学意义(P<0.05);两组患者第1年、第2年、第3年总生存率比较,差异均无统计学意义(P>0.05);两组患者药物治疗期间头痛、轻度皮肤黏膜干燥、消化道症状、心肌缺血等不良反应发生率比较,差异无统计学意义(P>0.05)。结论急性早幼粒细胞白血病患者在接受常规化疗及全反式维甲酸药物治疗基础上联合使用三氧化二砷疗效确切,患者治疗后各临床症状及体征得到更好更快缓解,完全缓解率高,复发风险明显降低,且不会增加患者消化道症状、心肌缺血等不良反应的发生,安全性理想。Objective To investigate the effect of arsenic trioxide combined with all-traMs retinoic acid in the treatment of the patients with acute promyelocytic leukemia. Methods 60 patients with acute promyelocytic leukemia who were admitted to our hospital from October 2012 to October 2014 were selected. According to the random number table method, they were divided into two groups, with 30 cases in each group. The control group was given chemotherapy alone, and the chemotherapy and all-traMs retinoic acid were given alternately. The patients in the observation group were given arsenic trioxide in combination with the control group. The complete remission rate, early mortality rate, re- currence rate, and overall survival rate in the first, second, and third years were compared between the two groups. At the same time, the adverse reactions such as headache, mild skin mucous membrane dryness, gastrointestinal symptoms, and myocardial ischemia occurring during the drug treatment were recorded in the two groups of patients. Results There was no statistically significant difference in the early mortality rate between the two groups（P〉0.05）; the complete remission rate was higher in the observation group than that in the control group, and the relapse rate was lower than that in the control group. The average time of complete remission was shorter than that in the control group, and the difference was statistically significant （P〈0.05）; there was no statistically significant difference in the overall survival rate in the first, second and third year in the two groups （P〉0.05）; there was no statistically significant difference in the incidence rate of adverse reactions such as headache, mild skin mucous membrane dryness, gastrointestinal symptoms, and myocardial ischemia during the drug treatment period between the two groups（P〉0.05）. Conclusion The application of arsenic trioxide in combination with conventional chemotherapy and all-traMs retinoic acid drug treatment is effective in the patients with

关 键 词：急性早幼粒细胞白血病 三氧化二砷 全反式维甲酸 不良反应 

分 类 号：R733.7[医药卫生—肿瘤]