三氧化二砷联合化疗治疗急性早幼粒细胞白血病的疗效观察

目的:观察三氧化二砷(As2O3)联合化疗治疗急性早幼粒细胞白血病(APL)的疗效.方法:46例初治APL患者均采用As2O3诱导治疗,完全缓解(CR)后用DA或MA方案巩固1个疗程,以后As2O3与化疗交替治疗,每3月1次,连续治疗3年.再继以甲氧蝶呤片与巯嘌呤片维持治疗1年.结果:46例患者有38例(82.6％)达到CR,34例坚持治疗者持续缓解,缓解时间17～119个月,中位缓解时间67个月；4例CR2患者缓解时间43～ 71个月,中位缓解时间54个月.38例患者仍处于CR,生存时间131～ 18个月,中位生存时间65个月.结论:APL患者CR后,采取每年4个周期的巩固和维持方案序贯治疗,减少了化疗及As2O3的疗程,避免了长期连续用药所致的耐药,减少了药物的副作用,复发率很低.

Observation on therapeutic effect of arsenic trioxide combined with chemotherapy in treatment of acute promyelocvtic leukemia

Objective:To observe the therapeutic effect of asenic trioxide combined with chemotherapy in treatment of acute promyelocytic leukemia(APL).Methods:Forty-six patients with newly diagnosed APL were treated with arsenic trioxide until complete remission(CR).One cycle of DA or MA regimen were given as consolidation,and then asenic trioxide or chemotherapy alternately once every 3 months for 3 years.6-MP and MTX maintained for one year.Results:Of the 46 patients,38 achieved CR(82.6%),34 persisted in treatment sustained remission,remission time was 17~119 months,median response duration was 67 months;4 cases of CR2 with a remission for 43~71 months,with median remission period for 54 months.38 patients were still in remission,survival time was 132~18 months,the median survival time was 65 months.Conclusions:Four cycles of consolidation and maintaining programs after CR may reduce the chemotherapy and courses of As2O3 for APL patients,and avoid drug resistance caused by long-term continuous medication,reduce side effects of drugs,and the recurrence rate is low.