临床儿科杂志
臨床兒科雜誌
림상인과잡지
2014年
5期
405-409
,共5页
王静%贾月萍%刘桂兰%陆爱东%张乐萍%左英熹%王彬
王靜%賈月萍%劉桂蘭%陸愛東%張樂萍%左英熹%王彬
왕정%가월평%류계란%륙애동%장악평%좌영희%왕빈
急性早幼粒细胞白血病%蒽环类%诱导治疗%临床分析%儿童
急性早幼粒細胞白血病%蒽環類%誘導治療%臨床分析%兒童
급성조유립세포백혈병%은배류%유도치료%림상분석%인동
acute promyelocytic leukemia%antharcycline%induction therapy%clinical analysis%child
目的：比较全反式维甲酸（ATRA）和三氧化二砷（As2O3）联合与不联合蒽环类药物诱导治疗儿童急性早幼粒细胞白血病（APL）的疗效和不良反应。方法回顾性分析2002年1月1日至2012年12月31日初治的46例APL患儿的临床资料，并根据不同诱导化疗方案和初始白细胞高低进行分组和对比分析。结果30例不加蒽环组患儿中有2例早期死亡，而16例加蒽环组患儿无一早期死亡。加蒽环组与不加蒽环组的完全缓解率、达分子学缓解时间和诱导化疗结束时微小残留病定量分析的差异均无统计学意义（P>0.05）。加蒽环组的高白细胞持续时间明显短于不加蒽环组，差异有统计学意义（P<0.05）。全体加蒽环组和不加蒽环组的凝血异常时间、肝脏毒性、感染率差异无统计学意义（P均>0.05）。结论儿童APL诱导化疗中联合蒽环类药物可减少高白细胞持续时间，降低白细胞峰值，有助于减少早期死亡。
目的：比較全反式維甲痠（ATRA）和三氧化二砷（As2O3）聯閤與不聯閤蒽環類藥物誘導治療兒童急性早幼粒細胞白血病（APL）的療效和不良反應。方法迴顧性分析2002年1月1日至2012年12月31日初治的46例APL患兒的臨床資料，併根據不同誘導化療方案和初始白細胞高低進行分組和對比分析。結果30例不加蒽環組患兒中有2例早期死亡，而16例加蒽環組患兒無一早期死亡。加蒽環組與不加蒽環組的完全緩解率、達分子學緩解時間和誘導化療結束時微小殘留病定量分析的差異均無統計學意義（P>0.05）。加蒽環組的高白細胞持續時間明顯短于不加蒽環組，差異有統計學意義（P<0.05）。全體加蒽環組和不加蒽環組的凝血異常時間、肝髒毒性、感染率差異無統計學意義（P均>0.05）。結論兒童APL誘導化療中聯閤蒽環類藥物可減少高白細胞持續時間，降低白細胞峰值，有助于減少早期死亡。
목적：비교전반식유갑산（ATRA）화삼양화이신（As2O3）연합여불연합은배류약물유도치료인동급성조유립세포백혈병（APL）적료효화불량반응。방법회고성분석2002년1월1일지2012년12월31일초치적46례APL환인적림상자료，병근거불동유도화료방안화초시백세포고저진행분조화대비분석。결과30례불가은배조환인중유2례조기사망，이16례가은배조환인무일조기사망。가은배조여불가은배조적완전완해솔、체분자학완해시간화유도화료결속시미소잔류병정량분석적차이균무통계학의의（P>0.05）。가은배조적고백세포지속시간명현단우불가은배조，차이유통계학의의（P<0.05）。전체가은배조화불가은배조적응혈이상시간、간장독성、감염솔차이무통계학의의（P균>0.05）。결론인동APL유도화료중연합은배류약물가감소고백세포지속시간，강저백세포봉치，유조우감소조기사망。
Objectives To compare the efficacy and adverse effects of combining all-trans retinoic acid and arsenic triox-ide with or without anthracyclines on the treatment of childhood acute promyelocytic leukemia (APL) patients. Methods The retrospective study included 46 children as newly diagnosed APL from January 1st, 2001 to December 31st , 2012. Efficacy and adverse effects for different induction therapies and in high and low white blood cell (WBC) count subgroups were studied. Results In the non antharcycline containing group, 2 patients died during remission induction, and in the antharcycline containing group none of the patients died. No statistical difference was observed between the antharcycline containing group and the non antharcycline containing group in complete remission, the length of time to achieve molecular complete remission and minimal residual disease quantitative analysis at the end of the induction. The mean duration of high WBC count subgroup in the anthar-cycline containing group was shortened than that of the non antharcycline containing group (P<0.05). The recovery time of the abnormal coagulation was found similar between these two groups. Conclusions The use of antharcycline in induction therapy could shorten the duration of high WBC count and reduced the WBC count peak , thus reduces the risk of early death.
