高三尖杉酯碱联合维甲酸和三氧化二砷治疗急性早幼粒细胞白血病的临床研究
고삼첨삼지감연합유갑산화삼양화이신치료급성조유립세포백혈병적림상연구
Clinical investigation of homoharringtonine in combination with all-transretinoic acid and arsenic trioxide for acute promyelocytic leukemia
  • 万方数据
    中华血液学杂志 중화혈액학잡지
    Chinese Journal of Hematology
    2013年 2期 144-148 ,共5页

    裴仁治%李双月%张丕胜%马俊霞%刘旭辉%杜小红%陈冬%沙科娅%陈列光%曹俊杰%庄贤栩%吴静怡%林丽%范峥%叶佩佩%唐善浩%张碧波%史晓薇

    배인치%리쌍월%장비성%마준하%류욱휘%두소홍%진동%사과아%진렬광%조준걸%장현허%오정이%림려%범쟁%협패패%당선호%장벽파%사효미

    白血病,早幼粒细胞,急性%高三尖杉酯碱%维甲酸%三氧化二砷 白血病,早幼粒細胞,急性%高三尖杉酯堿%維甲痠%三氧化二砷
    백혈병,조유립세포,급성%고삼첨삼지감%유갑산%삼양화이신
    Leukemia,promyelocytic,acute%Homoharringtonine%Retinoic acid%Arsenic trioxide
    目的 观察高三尖杉酯碱(HHT)联合全反式维甲酸(ATRA)和三氧化二砷(As2O3)治疗初治急性早幼粒细胞白血病(APL)的临床疗效、诱导治疗期不良反应及治疗费用.方法 回顾性分析HHT联合ATRA 和As2O3方案(观察组)、去甲氧柔红霉素(IDA)联合ATRA 和As2O3方案(对照组)治疗初治APL的临床资料,其中观察组14例,对照组21例,比较两组临床疗效、诱导治疗期不良反应及治疗费用.结果 ①观察组和对照组CR率分别为92.9%(14例中13例)、95.2%(21例中20例),获得CR的时间分别为 (28.1±3.8)、(31.7±4.2)d;诱导缓解后观察组和对照组PML-RARα融合基因阴性率分别为76.9%(13例中10例)、75.0%(20例中15例);CR患者序贯治疗第1周期结束后PML-RARα融合基因阴性率分别为100.0%和95.0%,差异均无统计学意义(P>0.05).②观察组和对照组5年总生存(OS)率分别为(92.6±0.6)%、(89.9±0.5)%;5年无病生存(DFS)率分别为100.0%、(86.8±0.6)%,差异均无统计学意义(P>0.05).③诱导治疗期间,观察组和对照组感染发生率分别为23.1%和60.0%;机采血小板输注量分别为(54.7±29.6)、(76.5±25.6) U;新鲜冰冻血浆输注量分别为(1157.1±238.4)、(1423.5±324.6)ml;剔除HHT和IDA费用后,总的医疗费用分别为(36074.9±1245.6)、(50564.5±3658.4)元,差异均有统计学意义(P<0.05).结论 HHT联合ATRA和As2O3治疗初发APL患者疗效好,长期生存率高,且费用低,是APL治疗的合理选择之一.
    목적 관찰고삼첨삼지감(HHT)연합전반식유갑산(ATRA)화삼양화이신(As2O3)치료초치급성조유립세포백혈병(APL)적림상료효、유도치료기불량반응급치료비용.방법 회고성분석HHT연합ATRA 화As2O3방안(관찰조)、거갑양유홍매소(IDA)연합ATRA 화As2O3방안(대조조)치료초치APL적림상자료,기중관찰조14례,대조조21례,비교량조림상료효、유도치료기불량반응급치료비용.결과 ①관찰조화대조조CR솔분별위92.9%(14례중13례)、95.2%(21례중20례),획득CR적시간분별위 (28.1±3.8)、(31.7±4.2)d;유도완해후관찰조화대조조PML-RARα융합기인음성솔분별위76.9%(13례중10례)、75.0%(20례중15례);CR환자서관치료제1주기결속후PML-RARα융합기인음성솔분별위100.0%화95.0%,차이균무통계학의의(P>0.05).②관찰조화대조조5년총생존(OS)솔분별위(92.6±0.6)%、(89.9±0.5)%;5년무병생존(DFS)솔분별위100.0%、(86.8±0.6)%,차이균무통계학의의(P>0.05).③유도치료기간,관찰조화대조조감염발생솔분별위23.1%화60.0%;궤채혈소판수주량분별위(54.7±29.6)、(76.5±25.6) U;신선빙동혈장수주량분별위(1157.1±238.4)、(1423.5±324.6)ml;척제HHT화IDA비용후,총적의료비용분별위(36074.9±1245.6)、(50564.5±3658.4)원,차이균유통계학의의(P<0.05).결론 HHT연합ATRA화As2O3치료초발APL환자료효호,장기생존솔고,차비용저,시APL치료적합리선택지일.
    Objective To study the clinical outcome, adverse effect and treatment cost of homoharringtonine(HHT) in combination with all-trans retinoic acid(ATRA) and arsenic trioxide(AS2O3) for newly diagnosed with patients acute promyelocytic leukemia (APL). Methods Clinical data of treatment of newly diagnosed patients with APL in experimental group(HHT+ATRA+AS2O3, n=14)and control group[Idarubicine(IDA)+ATRA+AS2O3, n=21] were analyzed retrospectively. The therapeutic effects, side effects and costs during induction therapy were compared between the two groups. Results ①The complete remission(CR)rate were 92.9%(13/14) and 95.2%(20/21) in experimental group and control group, respectively. The time to achieve CR were (28.1±3.8) and (31.7±4.2) days, respectively(P>0.05). The negative rate of PML-RARα fusion gene at the time of CR were 76.9%(10/13)and 75.0%(15/20), respectively, and that in CR patient at the end of the first cycle treatment were 100.0%(13/13)and 95.0%(19/20), respectively(P>0.05). ②5-year overall survival (OS) rate were (92.6±0.6)% and(89.9±0.5)%, respectively(P>0.05), 5-year disease free survival (DFS) rate were 100.0% and(86.8±0.6)%, respectively(P>0.05). ③During induction therapy, the incidence of infection in experimental and control group were 23.1%(3/13), 60.0%(12/20), respectively (P<0.05). The amount of platelet transfusion were (54.7±29.6) and (76.5±25.6) units, respectively(P>0.05), and that of fresh frozen plasma were (1157.1±238.4) and (1423.5±324.6) ml, respectively(P>0.05). The total medical costs(excluding HHT and IDA) in experimental and control group were (36074.9±1245.6)and(50564.5±3658.4)CNY, respectively (P<0.05). Conclusion HHT in combination with ATRA and AS2O3 regimen for newly diagnosed APL has a better efficacy, a higher long-term survival rate, and a lower costs, which is one of the reasonable choice.
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