CAJ | 학술논문

目的观察全反式维甲酸(ATRA)联合三氧化二砷(As2O3)治疗初诊急性早幼粒细胞白血病(APL)的疗效及不良反应.方法对ATRA每天25mg/m2联合As2O310mg/d(联合组)治疗的35例APL患者达完全缓解(CR)时间、CR率、早期病死率及不良反应进行观察,并与单用As2O3 10 mg/d(单药组)治疗的33例进行比较.结果联合组CR率为94.3%(33/35),与单药组[90.9%(30/33)]比较差异无统计学意义(P>0.05);联合组获得CR时间为26.1 d,短于单药组的30.5 d,差异有统计学意义(P<0.05);联合组与单药组APL分化综合征及不良反应发生率、早期病死率比较,差异均无统计学意义(均P>0.05);高WBC组比中、低WBC组CR率低,死亡率高,差异均有统计学意义(均P<0.05),低WBC组与中WBC组差异无统计学意义(P>0.05).结论 As2O3联合ATRA较单用As2O3治疗初诊APL获得CR时间短,WBC>10×109/L为预后不良的因素,APL分化综合征应尽早发现,及时处理.
목적 관찰전반식유갑산(ATRA)연합삼양화이신(As2O3)치료초진급성조유립세포백혈병(APL)적료효급불량반응.방법 대ATRA매천25mg/m2연합As2O310mg/d(연합조)치료적35례APL환자체완전완해(CR)시간、CR솔、조기병사솔급불량반응진행관찰,병여단용As2O3 10 mg/d(단약조)치료적33례진행비교.결과 연합조CR솔위94.3%(33/35),여단약조[90.9%(30/33)]비교차이무통계학의의(P>0.05);연합조획득CR시간위26.1 d,단우단약조적30.5 d,차이유통계학의의(P<0.05);연합조여단약조APL분화종합정급불량반응발생솔、조기병사솔비교,차이균무통계학의의(균P>0.05);고WBC조비중、저WBC조CR솔저,사망솔고,차이균유통계학의의(균P<0.05),저WBC조여중WBC조차이무통계학의의(P>0.05).결론 As2O3연합ATRA교단용As2O3치료초진APL획득CR시간단,WBC>10×109/L위예후불량적인소,APL분화종합정응진조발현,급시처리.
Objective To investigate the therapeutic efficacy and side effects of arsenic trioxide (As2O3) with ATRA on newly-diagnosed patients with acute promyelocytic leukemia (APL). Methods 35 patients of newly-diagnosed APL received As2O3 with ATRA treatment. The therapeutic effects were compared with As2O3 treatment on 33 patients. The dose were adjusted according with As2O3 0.16 mg·kg-2·d-1 and ATRA 25 mg·m-2·d-1 until complete remission (CR). The CR rate, period to CR, the incidence of early death and side effects were observed in two groups. Results There was no significant difference in CR rate, in which 94.3 % for As2O3 with ATRA group and 90.9 % for As2O3 group (P >0.05). Significant difference was observed in the period to CR, in which the medium time to CR was 26.1 days for As2O3 with ATRA group and 30.5 days for As2O3 group (P <0.05). No significant differences was detected in APL associated syndrome, the occurrence of cytoxic responses and the incidence of early death. The death rate was higher in high WBC group than that in middle and low WBC group, with statistical difference (P <0.05), but there was no obvious difference between lower WBC and middle WBC group (P >0.05). Conclusion The treatment combined with As2O3 and ATRA could lessen the time of reaching CR. The WBC count > 10×l09/L was one of the main causes of therapy associated death and the APL differentiation syndrome should be detected and given attention immediately.