全反式维甲酸治疗急性早幼粒细胞白血病40例

本文报告用ＡＴＲＡ分化诱导４０例ＡＰＬ，男２７例，女１３切，年龄１１～６２岁，ＡＴＲＡ剂量每天４０ｍｓ／ｍ￣２，３１例在ＣＲ后以ＨＯＡＰ方案或ＤＡ方案化疗两疗程。其后除９例中途停药，均以Ａ－ＴＲＡ间隔１４天２疗程化疗每月主替至复发。用ＡＴＲＡ至ＣＲ时间２３～５９天，ＣＲ率８７．５％，中位级解期１６个月，其中５例持续缓解达３年以上，３例死于脑出血，两例分别死于感染和ＡＴＲＡ综合征，还见到少见特异急性胰腺炎，假性脑瘤综合征和ＡＴＲＡ综合征各１例。

ALL TRANS RETINOIC ACIDS INDUCED DIFFERANTION THERAPY FOR 40 CASE OF ACUTE PROMYELOCYTIC LEUKEMIA

The ail-trans retinoic acid (ATRA) induced differentiation therapy was applied to 40 cases (27 males,13 females; age 11-62, of acute promyelocytic leukemia. ATRA was administered in a dose of 40mg/m2 daily (for 23.59 days) untill complete remission. After complete remission,23 cases received 2 courses of HOAP regime (H 2-4mg/d intravenous infusion,dl-7;VCR 1-2mg/d iv at first day;Ara-C 25-50mg H b.1.dl-7; prednisone 20mg b.1.dl-7) and 8 cases received 2 courses of DA regime (DNR 20-40mg iv dl-3: Ara-C 25-50 ms H b.1.d. dl-7). Afterwwards, the ATRA therapy and two courses of the same chemotherapy regime were administered alternatively each in a month,with an interval of 14 days between two courses of chemotherapy. The complete remission rate was 87.5%. The median of remission duration was 16 months, with 5 cases enjoying a continuous remission over 3 years. The commonly seen side effects were skin dryness,desquamation,abnormal liver function and bony pain. Addtionally,some rare special side reactions,including pseudotumor syndrome,acute pancrcatitis and ATRA syndrome,were also found (each in one case).