三氧化二砷治疗初发急性早幼粒细胞白血病的临床观察

目的:观察三氧化二砷(As2O3)治疗初发急性早幼粒细胞白血病(APL)的疗效和不良反应。方法:对As2O3治疗的26例APL患者的完全缓解(CR)率、达CR所需时间、早期病死率和不良反应进行观察,并与应用全反式维甲酸(ATRA)治疗的31例APL进行比较。治疗方法为As2O30.16mg/(kg.d)或全反式维甲酸(ATRA)25mg/(m.d)直至CR,根据外周血白细胞计数、副作用调整As2O3和ATRA的剂量。结果:As2O3组与ATRA组相比,在CR率(分别为84.6%、83.9%)、获得CR所需的时间(平均时间分别为41d、47d)、早期病死率(分别11.5%、12.9%)均无统计学意义(P>0.05);As2O3组比ATRA组的毒副作用少(P<0.05)。结论:与ATRA治疗初发APL相比,As2O3的疗效相当,不良反应少,是一种有效的治疗初发APL的方案。

Clinical Observation of Arsenic Trioxide on Newly-diagnosed Patients of Acute Promyelocytic Leukemia

Objective To observe the therapeutic efficacy and side effects of arsenic trioxide （ As2O3 ） on newly-diagnosed patients with acute promyelocytic leukemia（APL）. Methods 26 patients of newly-diagalosed APL, underwent As2O3 therapy. The therapeutic effects was compared with ATRA treatment on 31 patients. The two groups were treated respectively with As2O3 0.16 mg/（kg · d） and ATRA 25 mg/（ m · d） until complete remission（CR）. The dose were adjusted according to white blood cell（WBC） counts and side effects. CR rate, period to CR,incidence of early death and side effects were observed in two groups. Results There was no significantly difference in CR rate （84.6% for As2O3 group and 83.9% for ATRA group,P 〉 0.05 ）, the period to CR （ the medium time to CR was 41 days for As2O3 group and 47 days for ATRA group, P 〉 0.05 ） and the incidence of early death（ 11.5% for As2O3 group and 12.9% for ATRA group P 〉 0.05 ）. As2O3 had less toxic side effect as compared to ATRA. Conclusion As compared to ATRA, As2O3 has therapeutic equivalence and less toxic side effect. It is an efficient therapeutic approach to newly-diagnosed APL patients.