ATRA与As2O3并化疗药物治疗急性早幼粒细胞白血病病人的效果

目的探讨全反式维甲酸（ATRA）与三氧化二砷（As2O3）和化疗药物三者联合（三联疗法）治疗初诊急性早幼粒细胞白血病（APL）的疗效和不良反应。方法72例APL病人均采用三联疗法治疗，观察其疗效和不良反应。结果72例初发APL病人，早期死亡7例（9．7％），47例病人获得完全缓解（CR），占72．3％；16例部分缓解（PR），占24．6％；2例未缓解（NR），占3．1％，总有效率96．9％。获得缓解的时间为20～48d，平均（30．8±6．3）d。死亡组治疗前白细胞数与各缓解组相比，差异有统计学意义（uc=18～63，P〈0．05）。治疗过程中元严重不良反应发生，仅1例发生维甲酸综合征。结论三联疗法治疗APL效果满意，不良反应少。但在获得缓解所需时间、成分输血的数量、费用等方面可能并无明显优势。

THE EFFECT OF ATRA, As2O3 PLUS CHEMOTHERAPEUTICS ON ACUTE PROMYELOCYTIC LEUKEMIA

Objective To observe the efficacy and side effects of combined therapy with all-trans retinoic acid （ATRA）, arsenic trioxide （As203） and chemotherapeutics for newly diagnosed acute promyelocytic leukemia （APL）. Methods Seventy- two APL patients were treated with combined therapy of ARTA, As2O3 and chemotherapeuics, its efficacy and side effects were observed. Results Of the 72 patients treated, seven （9.7%） died early, 47 （72.3%） achieved complete remission （CR）, 16 （24. 6%） got partial remission （PR） and two （3. 1%） with non-remission （NR）. The total effective rate was 96. 9%. The CR time （mean） was 20-48 （30.8±6.3） days. For those who died, the number of leukocytes before treatment was significantly different from those who relieved （uc = 18-63, P〈0.05）. No severe side effects were observed except one who developed retinoic acid syndrome. Conclusion The effect of the combined therapy of APL is satisfactory with few side effeets, but it has no obvious superiority in terms of the remission time, amount of component transfusion and expense.