16例高白细胞APL诱导缓解治疗临床分析

目的评价在诱导缓解治疗阶段应用柔红霉素、阿糖胞苷(DA方案)和全反式维甲酸(ATRA)双诱导治疗初诊高白细胞急性早幼粒细胞白血病(APL)的临床疗效及不良反应。方法回顾性分析2002～2011年深圳市人民医院收治的16例在诱导缓解治疗阶段均接受柔红霉素、阿糖胞苷和全反式维甲酸方案双诱导治疗的高白细胞急性早幼粒细胞白血病患者资料,对患者的临床缓解情况及治疗方案的不良反应进行分析。结果柔红霉素、阿糖胞苷联合全反式维甲酸方案双诱导治疗高白细胞急性早幼粒细胞白血病的临床完全缓解率达87.5%,1例死于肺部严重感染,1例死于颅内出血,3例患者出现维甲酸综合征且经治疗后好转。结论在诱导缓解阶段应用柔红霉素、阿糖胞苷联合全反式维甲酸方案双诱导治疗初诊高白细胞急性早幼粒细胞白血病完全缓解率高,不良反应少,是一种很好的治疗选择。

Clinical Analysis of 16 Patients with Acute Promyelocytic Leukemia with High WBC Counts in Induction Therapy

Objective To evaluate the clinical outcomes and adverse reactions of induction therapy with daunorubicin(DNR) and cytarabine(Ara-C) plus all-trans retinoic acid(ATRA) in patients with newly diagnosed acute promyelocytic leukemia(APL) with high WBC counts.Methods Sixteen patients with hyperleukocytic APL undergoing induction therapy with DA(daunorubicin +cytarabine) and retinoic acid(ATRA) from January 2002 to October 2011 were retrospectively analyzed to evaluate the clinical efficacy and adverse reactions.Results The remission induction rate was 87.5%.One patient died of severe lung infection and one patient died of intracranial hemorrhage;retinoic acid syndrome(RAS) arose in three patients and recovered after treatment.Conclusion DA combination with ATRA,with high efficacy and low toxicity,should be a good choice for patients with newly diagnosed APL with high WBC count as induction therapy.