全反式维甲酸、三氧化二砷、化疗联合治疗急性早幼粒细胞白血病疗效观察

 目的　评估全反式维甲酸（ATRA）、三氧化二砷（As2O3）、化疗联合治疗初诊急性早幼粒细胞白血病（APL）的疗效和患者不良反应。方法　对40例采用ATRA、As2O3、化疗三联疗法治疗的APL患者的临床资料进行回顾性分析，观察其疗效及不良反应。结果　总体CR率92.5 %（37／40），完全缓解所需中位时间27（22～61）d；白细胞≥10×109／L组CR率72.7 %（8／11），白细胞＜10×109／L组CR率100 %（29／29），差异有统计学意义（χ2＝8.550，P＝0.004）；治疗过程中无严重不良反应，仅1例发生维甲酸综合征。结论　ATRA、As2O3、化疗联合应用可作为APL患者的首选治疗方案。

Clinical observation of the effect of ATRA, As2O3 and chemotherapy on acute promyelocytic leukemia

Objective To observe the efficacy and side effects of combined therapy with victoria A acid,arsenic trioxide and chemotherapeutics for newly diagnosed acute promyeloeytic leukemia （APL）. Methods 40 cases of patients were treated with combined therapy of ATRA, As203 and chemotherapy. The efficacy and side effects were analysed. Results 92.5 % （37/40） achieved complete remission（CR）. The CR time was 27（22-61） d by average; leukocytes I〉 10xl09/L group complete remission was 72.7 % （8/11）, leukocytes 〈 10×l09/L group complete remission was 100 % （29/29）. There was a significant different （X^2 =8.550, P =0.004）. No severe side effects was observed except one who developed retinoic acid syndrom. Conclusion The combined regimen of ATRA and As203 with chemotherapy for acute promyelocytic leukemia should be the first choice management.