全反式维甲酸联合砷剂序贯治疗成人APL患者的疗效  

Sequential Treatment of Adult APL Patients with All Trans Retinoic Acid Combined with Arsenic

作　　者：史瑞 温静 吴雯 宋艳萍[1] 雷小茹 SHI Rui;WEN Jing;WU Wen(Xi'an Central Hospital and Xi'an Institute of Hematology,Xi'an Shaanxi 710004)

机构地区：[1]西安市中心医院暨西安市血液病研究所,陕西西安710004

出　　处：《医学临床研究》2022年第9期1315-1317,1321,共4页Journal of Clinical Research

基　　金：陕西省自然科学基础研究项目(编号:2013JM4016)。

摘　　要：【目的】探讨全反式维甲酸(ATRA)联合砷剂序贯治疗成人急性早幼粒细胞白血病(APL)患者的疗效。【方法】选取本院收治的94例APL患者的临床资料进行回顾性分析,按治疗方法的不同分为观察组及对照组,每组47例。对照组予以ATRA治疗,观察组在对照组基础上联合砷剂序贯治疗。对比两组患者完全缓解(CR)率及1年累积生存率,比较两组CR患者达到CR的时间、PML-RARα转阴率、复发率、早幼粒细胞比例、白细胞计数和不良反应发生情况。【结果】观察组获得CR例数和未获得CR例数分别为41例(87.23%)和6例(12.77%),对照组获得CR例数和未获得CR例数分别为40例(85.11%)和7例(14.89%),两组比较差异均无统计学意义(P>0.05)。观察组患者达到CR时间明显短于对照组,观察组PML-RARα转阴率高于对照组,复发率显著低于对照组,且差异均有统计学意义(P<0.05)。两组患者治疗前早幼粒细胞比例和白细胞计数比较,差异无统计学意义(P>0.05);两组治疗后早幼粒细胞比例和白细胞计数均明显低于治疗前(P<0.05),且观察组早幼粒细胞比例和白细胞计数均明显低于对照组(P<0.05)。两组CR患者1年累积生存率相比较,差异无统计学意义(P>0.05),两组CR患者总不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】APL患者行ATRA联合砷剂序贯治疗效果满意,PML-RARα转阴率高,复发率少,1年生存率高,两种治疗方法用药安全性均较高。【Objective】To investigate the efficacy of all trans retinoic acid(ATRA)combined with arsenic in sequential treatment of acute promyelocytic leukemia(APL).【Methods】The clinical data of 94 APL patients admitted to our hospital were retrospectively analyzed.They were divided into observation group and control group according to different treatment methods,with 47 cases in each group.The control group was treated with ATRA,and the observation group was treated with arsenic based sequential therapy on the basis of the control group.Complete remission(CR)rate and 1-year cumulative survival rate were compared between the two groups.Time for CR patients to reach CR,PML-RARα.The negative conversion rate,recurrence rate,promyelocyte ratio,total leukocyte count and adverse reactions were compared.【Results】The number of CR cases obtained and the number of CR cases not obtained in the observation group were 41(87.23%)and 6(12.77%)respectively,while the number of CR cases obtained and the number of CR cases not obtained in the control group were 40(85.11%)and 7(14.89%)respectively,and there was no significant difference between the two groups(P>0.05).The time for patients in the observation group to reach CR was significantly shorter than that in the control group.PML-RARαin the observation group.The negative conversion rate was higher than that of the control group,and the recurrence rate was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the percentage of promyelocytes and total leukocytes between the two groups before treatment(P>0.05);After treatment,the percentage of promyelocytes and total leukocytes in the two groups were significantly lower than those before treatment(P<0.05),and the percentage of promyelocytes and total leukocytes in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the 1-year cumulative survival rate between the t

关 键 词：白血病 早幼粒细胞 急性 维甲酸 砷剂 治疗结果 

分 类 号：R733.71[医药卫生—肿瘤]