三联疗法治疗急性早幼粒性白血病临床观察

目的:观察三联疗法治疗急性早幼粒性白血病(acute promylocytic leukemia,APL)的疗效。方法:治疗组采用三联疗法(维甲酸、亚砷酸(AS2O3)、小剂量化疗)进行APL初发病时治疗;对照组采用常规化疗法进行初发病时治疗,两组均进行序贯疗法治疗APL。结果:治疗组白细胞开始下降时间为6.8±1.4 d,对照组为12.3±2.3 d;嗜天青颗粒开始减少时间为8.9±2.1 d,对照组为15.5±3.6 d;细胞核分裂分化加速时间为10.7±2.3 d,对照组为18.9±3.8 d;凝血指标恢复正常时间为12.8±3.1 d,对照组为21.2±4.4 d;骨髓缓解时间为15.1±1.9 d,对照组为31.2±3.3 d;两组间比较有差异性。经过用三联疗法治疗后,治疗组化疗后反应和并发症较对照组明显减少,感染率也明显下降。治疗组完全缓解(CR)88.2%,无1例死亡;对照组完全缓解33.3%,3例合并脑出血死亡。结论:用维甲酸、亚砷酸、HAC小剂量化疗三联疗法治疗APL较一般方法疗效显著,而且能缩短达CR的时间,降低死亡率。

The clinical observation on acute promyelocytic leukemia(APL)treated by the combination of 3 therapies

Objective: Observe the results of acute promylocytic leukemia(APL) treated by the combinaton of 3 therapies.Methods: The experimental group was treated by the combination of 3 therapies,which are all-trans retinoic acid(ATRA),arsenious acid and HAC chemotherapy and the control group was treated by only ATRA therapy in earlier period.Results: 88.2% patients achieved CR in the experimental group,and 33.3% patients achieved CR in the control group.The time of white blood cells decreasing is 6.8±1.4 days in the experimental group,and in the control group the time is 12.3±2.3 days.The time of to azurophilic granule decrease is 8.9±2.1 days in the experimental group and it is 15.5±3.6 days in the control group.The time of nuclear differentiation is 10.7±2.3 days in the experimental group and in the control group it is 18.9±3.8 days.Coagulation factors became to recover in day 12.8±3.1 of the experimental group and it became to recover in day 21.2±4.4 of the control.The time of marrow remission is 15.1±1.9 days in the experimental group and it is 31.2±3.3 days in the control.There are significant differences in the two groups.Conclusion: the combination of 3 therapies is better than ATRA therapy,which can obtain shorter duration for achieving CR and reduce the death rate.