复方黄黛片为主的缓解后治疗方案对急性早幼粒细胞白血病长期生存的影响

目的探讨复方黄黛片为主的缓解后治疗方案对急性早幼粒细胞白血病(APL)患者长期生存的影响。方法 112例APL患者接受了复方黄黛片为主,且与HACP、HAOP、HAEP、HAMP联合化疗交替应用的缓解后治疗,通过骨髓象检查了解疾病复发情况及生存期。结果 (1)112例患者中,16例患者复发,复发率为14.29%,中位复发时间为12.5(4～67)个月;(2)中位随访时间为59(1～72)个月,1、2、3、4、5、6年实际无复发生存(RFS)率分别为92.86%、89.29%、88.39%、87.50%、86.61%、85.71%,预计RFS率分别为(92.45±2.57)%、(88.25±3.20)%、(87.09±3.36)%、(85.89±3.52)%、(84.44±3.75)%、(82.78±4.03)%;(3)完全缓解(CR)后治疗10疗程组与完全缓解(CR)后治疗≥10疗程组的复发率分别为34.29%、5.19%,CR后治疗10疗程组与CR后治疗≥10疗程组的RFS率分别为65.71%、94.81%,两组比较,差异有统计学意义(P0.01)。结论复方黄黛片主治方案是有效、可行的缓解后治疗方案。

Effect of Post-remission Therapy Mainly with Compound Huangdai Tablet on Long-term Survival of Patients with Acute Promyelocytic Leukemia

Objective To investigate the effect of post-remission therapy mainly with Compound Huangdai Tablet （CHDT） on long-term survival of patients with acute promyelocytic leukemia （APL）.Methods One hundred and twelve APL patients were treated after remission mainly with CHDT administered alternately with chemotherapeutic projects such as HACP,HAOP,HAEP and HAMP.The relapse rate and relapse-free survival （RFS） rate in them were estimated by bone marrow examination.Results The total relapse rate was 14.29% （16/112）,and the median time of relapse was 12.5 （4-67） months.Patients were followed up for 1-72 months,the median follow-up time being 59 months.The actual RFS rate of 1-,2-,3-,4-,5and 6-year was 92.86%,89.29%,88.39%,87.50%,86.61% and 85.71%,respectively,while the estimated RFS rate （%） of corresponding year was 92.45±2.57,88.25±3.20,87.09±3.36,85.89±3.52,84.44±3.75 and 82.78±4.03 respectively;the relapse rate in patients who received treatment after complete response for10 courses group was 34.29%,while in those treated for≥10 courses was 5.19%;and the RFS rate in them was 65.71% and 94.81% respectively,the difference between groups was statistically significant （P0.01）.Conclusion The postremission therapy mainly with CHDT is an effective and feasible program for the treatment of APL.