亚砷酸持续输注联合小剂量维A酸治疗急性早幼粒细胞性白血病临床观察

目的 探讨亚砷酸（ATO）持续输注联合小剂量维A酸（LD—ATRA）治疗急性早幼粒细胞白血病（APL）的有效性及安全性。方法6例初治APL采用ATO持续输注联合LD—ATRA方法治疗，ATO按10mg·d^-1加入5％葡萄糖500ml稀释，持续输注18h；ATRA按15mg·d^-1，连续口服1周：观察疗效、外周WBC、出凝血指标及不良反应？结果6例均达到CR，获CR时间为（25．3±1．03）d，无早期死亡与CNS—L发生。所有病例在治疗1周后，出凝血指标均恢复正常。外周血WBC均有增多，仅1例WBC超过30×10^9／L。不良反应轻，主要为Ⅰ～Ⅱ度肝功能损害，Ⅰ度恶心呕吐。结论ATO持续输注联合LD—ATRA方法治疗APL，具有疗效好，不良反应轻等优点，值得进一步研究.

Treatment of acute promyelocytic leukemia with intravenously continuous infusion arsenic trioxide and low-dose all-trans retinoic acid

Aim To explore the effect and safety of intravenously continuous infusion arsenic trioxide(ATO) and low-dose all-trans retinoic acid(ATRA) for patients with acute promyelocytic leukemia(APL).Methods 6 consecutive newly diagnosed patients were treated.ATO was continuously infused intravenously that was diluted in 500 ml of 5% glucose at 10 mg daily dose for 18 hours.15 mg·d-1 ATRA was administered orally continuously daily for a week.The complete remission rate,change of leukocyte and coagulopathy index and side effects were observed.Results 6 patients with APL achieved complete response(CR).The median time of CR were(25.3±1.03 d).No early death and DIC were observed.The abnormal coagulopathy index became normal after a week.Leukocytosis was observed in all patients,but only one had leukocytosis of more than 3000/μl.Side effects were generally mild.Grade 1 or 2 toxicity included liver function damage.Grade 1 toxicity included nausea/vomiting.Conclusion Treatment with intravenously continuous infusion ATO and LD-ATRA is an effective,and less toxic regimen in patients with APL.Results require further study.