CAJ | 학술논문

目的：研究全反式维甲酸（ATRA）联合亚砷酸（ATO）治疗初诊急性早幼粒细胞白血病（APL）的疗效。方法回顾性分析ATRA联合ATO诱导治疗＋序贯巩固化疗＋ ATO/ATRA维持治疗，对初诊急性早幼粒细胞白血病患者的疗效。并比较在高危组与中低危组间，及不同PML-RARa融合基因亚型组间的疗效差异。结果高危组和中低危组的完全缓解率分别为70．0％和96．9％，差异无统计学意义（P＝0．04），3年总生存率（OS）分别为（70．0±14．5）％，（96．9±3．1）％，差异有统计学意义（P＝0．01）；3年无病生存率（DFS）分别为（66．7％±19．2）％，（93．8±6．1）％，差异无统计学意义（P＝0．08）；PML-RARa融合基因BCR1亚型组与BCR3亚型组的完全缓解率分别为78．6％和95．6％，差异无统计学意义（P＝0．14），3年OS率分别为（95．7±4．3）％，（78．6±11．0）％，差异无统计学意义（P＝0．18）；DFS率分别为（92．9±6．9）％，（87．5±11．7）％，差异无统计学意义（P＝0．24）。结论 ATRA联合亚砷酸作为一线用药治疗初诊急性早幼粒细胞白血病，尤其对于BCR3亚型患者取得了非常好的疗效。
목적：연구전반식유갑산（ATRA）연합아신산（ATO）치료초진급성조유립세포백혈병（APL）적료효。방법회고성분석ATRA연합ATO유도치료＋서관공고화료＋ ATO/ATRA유지치료，대초진급성조유립세포백혈병환자적료효。병비교재고위조여중저위조간，급불동PML-RARa융합기인아형조간적료효차이。결과고위조화중저위조적완전완해솔분별위70．0％화96．9％，차이무통계학의의（P＝0．04），3년총생존솔（OS）분별위（70．0±14．5）％，（96．9±3．1）％，차이유통계학의의（P＝0．01）；3년무병생존솔（DFS）분별위（66．7％±19．2）％，（93．8±6．1）％，차이무통계학의의（P＝0．08）；PML-RARa융합기인BCR1아형조여BCR3아형조적완전완해솔분별위78．6％화95．6％，차이무통계학의의（P＝0．14），3년OS솔분별위（95．7±4．3）％，（78．6±11．0）％，차이무통계학의의（P＝0．18）；DFS솔분별위（92．9±6．9）％，（87．5±11．7）％，차이무통계학의의（P＝0．24）。결론 ATRA연합아신산작위일선용약치료초진급성조유립세포백혈병，우기대우BCR3아형환자취득료비상호적료효。
Objective To assess the efficacy of combination therapy with all-trans-retinoic acid (ATRA ) and arsenic trioxide (ATO) in treating patients with acute promyelocytic leukemia (APL) .Methods A retrospective study was conducted to evaluate the efficacy of combining ATO with ATRA based induction therapy ,followed by 3 courses of consolidation chemotherapy and 2-year sequential ATO/ATRA maintenance therapy in newly diagnosed APL ,and the efficacy between high risk group and low/inter-mediate risk group ,also between different PML-RARa isoform sub-group were compared .Results In high risk group and low/in-termediate risk group ,the complete remission(CR)rates were 70 .0% and 96 .9% (P=0 .04) ,respectively ;the 3 years overall sur-vival rates(OS) and disease free survival rates (DFS) were(70 .0 ± 14 .5)% ,(96 .9 ± 3 .1)% ,P= 0 .01 and(66 .7% ± 19 .2)% , (93 .8 ± 6 .1)% ,P=0 .08 ,respectively .In BCR1 group and BCR3 group ,the CR were 78 .6% and 95 .6% (P=0 .14) ,respectively ;the rates of 3 years OS and DFS were(95 .7 ± 4 .3)% ,(78 .6 ± 11 .0)% ,P=0 .18 ,and(92 .9 ± 6 .9)% ,(87 .5 ± 11 .7)% ,P=0 .24 , respectively .Conclusion The results indicate that ATO based first-line protocol is highly effective for treatment of newly diagnosed APL ,especially for the PML-RARa BCR3 isoform APL .