白血病·淋巴瘤
白血病·淋巴瘤
백혈병·림파류
JOURNAL OF LEUKEMIA & LYMPHOMA
2011年
5期
282-285
,共4页
三氧化二砷%全反式维甲酸%急性早幼粒细胞白血病
三氧化二砷%全反式維甲痠%急性早幼粒細胞白血病
삼양화이신%전반식유갑산%급성조유립세포백혈병
Arsenic trioxide%All-trans retinoic acid%Acute promyelocytic leukemia
目的 观察三氧化二砷(ATO)联合全反式维甲酸(ATRA)治疗初发急性早幼粒细胞白血病(APL)的疗效.方法 98例初发APL患者分为对照组和治疗组,对照组48例,治疗组50例.对照组采用常规ATRA+DA双诱导方案治疗;治疗组采用ATRA每天25 mg/m2,ATO每天0.15 mg/kg(ATRA后第10天开始)联合治疗,直至完全缓解(CR),CR后接受ATO和ATRA联合巩固治疗.比较两组CR率、PML-RAR α融合基因转阴时间及5年无病生存率.结果 对照组和治疗组CR率分别为89.5%(43/48)和90.0%(45/50),获得CR时间分别为(30.0±5.1)d和(28.1±4.4)d,两组CR率(x2=-0.068,P=0.946)及获得CR时间(t=1.757,P=0.083)相比差异均无统计学意义.在所有获得CR的患者中,3例分别在CR后第276、385和394天复发.所有患者发病时PML-RAR α融合基因均阳性,对照组和治疗组CR时分别有25.0%(5/20)和29.4%(5/17)转阴,巩固后分别有92.5%(37/40)和97.6%(41/42)转阴.对照组和治疗组5年无病生存率分别为(85.3±5.9)%和(87.6±5.6)%,差异无统计学意义(x2=0.232,P=0.630).结论 ATO联合ATRA能有效治疗初发APL患者,可以作为常规化疗方案外的另一选择.
目的 觀察三氧化二砷(ATO)聯閤全反式維甲痠(ATRA)治療初髮急性早幼粒細胞白血病(APL)的療效.方法 98例初髮APL患者分為對照組和治療組,對照組48例,治療組50例.對照組採用常規ATRA+DA雙誘導方案治療;治療組採用ATRA每天25 mg/m2,ATO每天0.15 mg/kg(ATRA後第10天開始)聯閤治療,直至完全緩解(CR),CR後接受ATO和ATRA聯閤鞏固治療.比較兩組CR率、PML-RAR α融閤基因轉陰時間及5年無病生存率.結果 對照組和治療組CR率分彆為89.5%(43/48)和90.0%(45/50),穫得CR時間分彆為(30.0±5.1)d和(28.1±4.4)d,兩組CR率(x2=-0.068,P=0.946)及穫得CR時間(t=1.757,P=0.083)相比差異均無統計學意義.在所有穫得CR的患者中,3例分彆在CR後第276、385和394天複髮.所有患者髮病時PML-RAR α融閤基因均暘性,對照組和治療組CR時分彆有25.0%(5/20)和29.4%(5/17)轉陰,鞏固後分彆有92.5%(37/40)和97.6%(41/42)轉陰.對照組和治療組5年無病生存率分彆為(85.3±5.9)%和(87.6±5.6)%,差異無統計學意義(x2=0.232,P=0.630).結論 ATO聯閤ATRA能有效治療初髮APL患者,可以作為常規化療方案外的另一選擇.
목적 관찰삼양화이신(ATO)연합전반식유갑산(ATRA)치료초발급성조유립세포백혈병(APL)적료효.방법 98례초발APL환자분위대조조화치료조,대조조48례,치료조50례.대조조채용상규ATRA+DA쌍유도방안치료;치료조채용ATRA매천25 mg/m2,ATO매천0.15 mg/kg(ATRA후제10천개시)연합치료,직지완전완해(CR),CR후접수ATO화ATRA연합공고치료.비교량조CR솔、PML-RAR α융합기인전음시간급5년무병생존솔.결과 대조조화치료조CR솔분별위89.5%(43/48)화90.0%(45/50),획득CR시간분별위(30.0±5.1)d화(28.1±4.4)d,량조CR솔(x2=-0.068,P=0.946)급획득CR시간(t=1.757,P=0.083)상비차이균무통계학의의.재소유획득CR적환자중,3례분별재CR후제276、385화394천복발.소유환자발병시PML-RAR α융합기인균양성,대조조화치료조CR시분별유25.0%(5/20)화29.4%(5/17)전음,공고후분별유92.5%(37/40)화97.6%(41/42)전음.대조조화치료조5년무병생존솔분별위(85.3±5.9)%화(87.6±5.6)%,차이무통계학의의(x2=0.232,P=0.630).결론 ATO연합ATRA능유효치료초발APL환자,가이작위상규화료방안외적령일선택.
Objective To study the efficacy of arsenic trioxide (ATO) combined all-trans retinoic acid (ATRA) in primary acute promyelocytic leukemia (APL) patients. Methods 98 patients with newly diagnosed APL were randomly divided into control (48 cases) and treatment group (50 cases). Control group received conventional ATRA+DA dual induction regimen and the treatment group received ATRA 25 mg·m-2·d-1, and ATO 0.15 mg·kg-1·d-1 beginning from 10 days later after administration of ATRA. After complete remission (CR), ATO and ATRA treatment were received. CR rate for consolidation, time of reaching clinical and molecular remission and 5-year disease-free survival were observed. Results CR rates were 89.6 % (43/48) and 90.0 % (45/50) in control group and treatment group, respectively, and the time of obtaining CR was (30.0±5.1) and (28.1 ±4.4) days, respectively. CR rates (x2 =-0.068, P =0.946) and time of reaching CR (t =1.757, P =0.083) in two groups showed no significant difference. In patients obtaining CR, 3 patients relapsed in 276, 385 and 394 days after CR, respectively. PML-RARα fusion gene was positive at diagnosis in all patients. The rate of negative of fusion gene at CR in control and treatment group was 25.0 % (5/20) and 29.4 % (5/17), respectively. The rate of negative of fusion gene after consolidation in control and treatment group was 92.5 % (37/40) and 97.6 % (41/42), respectively. 5-year disease-free survival rates of the control and treatment group was (85.3±5.9) % and (87.6±5.6) %, respectively. The difference was not statistically significant (x2 =0.232, P =0.630). Conclusion The regimen of ATO combined ATRA is effective in treating newly diagnosed APL patients, and can be used as an alternative regimen.
