四硫化四砷联合维甲酸、蒽环类药物治疗体系下附加染色体对急性早幼粒细胞白血病预后的影响

目的 分析在以维甲酸联合四硫化四砷、蒽环类药物为主的治疗体系下附加染色体对预后的影响以及有附加染色体异常患者的临床表现和对含四硫化四砷诱导治疗方案的反应性.方法 回顾性分析158例初治急性早幼粒细胞白血病患者临床资料.结果 附加染色体异常在急性早幼粒细胞白血病中占18.4%.其中三体8以及i17q-是最常见的附加异常,有附加染色体异常组患者弥散性血管内凝血发生率增高(P<0.05).在附加染色体异常组完全缓解率降低(75.9%vs 90.7%)、复发率增高(13.8%vs 6.2%)、中枢神经系统白血病的发生率增高(17.2%vs 6.2%),但差异未见统计学意义.两组生存率差异无统计学意义(P=0.160).结论 在此三类药物治疗体系下,尚未发现附加染色体对预后影响的统计学意义.

Effect of additional chromosome abnormalities on the outcome of newly diagnosed acute promyelocytic leukemia treated with red arsenic sulfide and all trans-retinoic acid plus anthracyclin based protocol

Objective To analyze the effect of additional chromosome abnormalities on the prognosis and the clinical manifestations of acute promyelocytic leukemia (APL) and the reaction of the patients with additional chromosomes to the treatment of combination of red arsenic sulfide, all trans-retinoic acid (ATRA) and anthracyclin. Methods The clinical data of 158 patients with newly diagnosed APL who were treated with combination of red arsenic sulfide, ATRA, and anthracyclin were analyzed retrospectively. Results The frequency of additional chromosome abnormalities in the APL patients was 18.4%, and trisome 8 and i17q- were the most to be seen. The disseminated intravascular coagulation rate of the patients with additional chromosome abnormality was 62. 1%, significantly higher than that of the patients without additional chromosome abnormality ( 35.6%, P 0. 05 ). The complete remission rate of the patients with additional chrosome abnormality was 75. 9%, not significantly lower than that of those without additional chrosome abnormality (90. 7% ) , and the relapse rate and incidence rate of central nervous system leukemia were 13.8% and 17. 2%, both higher, but not significantly, than those of the patients without additional chromosome abnormality ( 6. 2% and 6. 2% respectively ) ( all P0. 05 ). There was no significant difference in survival rate between these 2 groups (P = 0. 160 ). Conclusion Additional chromosome abnormality does not significantly influence the prognosis of APL treated with combination of red arsenic sulfide, ATRA, and anthracyclin.