中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2015年
5期
372-377
,共6页
陆滢%李枫林%牧启田%孟海涛%钱文斌%佟红艳%麦文渊%裴仁治%余梦霞
陸瀅%李楓林%牧啟田%孟海濤%錢文斌%佟紅豔%麥文淵%裴仁治%餘夢霞
륙형%리풍림%목계전%맹해도%전문빈%동홍염%맥문연%배인치%여몽하
白血病,早幼粒细胞,急性%维甲酸%三氧化二砷%存活率分析
白血病,早幼粒細胞,急性%維甲痠%三氧化二砷%存活率分析
백혈병,조유립세포,급성%유갑산%삼양화이신%존활솔분석
Leukemia,promyelocytic,acute%Tretinoin%Arsenic trioxide%Survival analysis
目的 探讨全反式维甲酸(ATRA)联合三氧化二砷(ATO)诱导及维持治疗方案对初诊急性早幼粒细胞白血病(APL)的临床疗效.方法 自2004年9月至2013年12月浙江大学附属第一医院血液科收治的298例初发APL患者,177例接受ATRA联合ATO治疗,116例接受ATRA联合化疗方案治疗.回顾性分析两种治疗方案对低中危组(WBC≤10× 109/L)和高危组(WBC> 10×109/L)APL患者的临床疗效.结果 在低中危APL患者中,ATRA联合化疗和ARTA联合ATO诱导及维持治疗方案的复发率分别为22.0%(20/91)和6.1% (6/98) (P=0.004);3年预计无复发生存(RFS)率分别为78.0%和92.9%(P=0.021).在高危APL患者中,ATRA联合化疗和ARTA联合ATO诱导及维持治疗方案的复发率分别为25.0%(4/16)和5.2%(3/58) (P=0.035);3年预计RFS率分别为80.8%和93.0%(P=0.063).两种方案治疗的低中危和高危患者比较,早期病死率、完全缓解率及总体生存率差异无统计学意义(P>0.05).结论 ATRA联合ATO诱导及维持治疗方案可以延长低中危APL患者的无复发生存时间,并能降低低、中、高危患者的复发率.
目的 探討全反式維甲痠(ATRA)聯閤三氧化二砷(ATO)誘導及維持治療方案對初診急性早幼粒細胞白血病(APL)的臨床療效.方法 自2004年9月至2013年12月浙江大學附屬第一醫院血液科收治的298例初髮APL患者,177例接受ATRA聯閤ATO治療,116例接受ATRA聯閤化療方案治療.迴顧性分析兩種治療方案對低中危組(WBC≤10× 109/L)和高危組(WBC> 10×109/L)APL患者的臨床療效.結果 在低中危APL患者中,ATRA聯閤化療和ARTA聯閤ATO誘導及維持治療方案的複髮率分彆為22.0%(20/91)和6.1% (6/98) (P=0.004);3年預計無複髮生存(RFS)率分彆為78.0%和92.9%(P=0.021).在高危APL患者中,ATRA聯閤化療和ARTA聯閤ATO誘導及維持治療方案的複髮率分彆為25.0%(4/16)和5.2%(3/58) (P=0.035);3年預計RFS率分彆為80.8%和93.0%(P=0.063).兩種方案治療的低中危和高危患者比較,早期病死率、完全緩解率及總體生存率差異無統計學意義(P>0.05).結論 ATRA聯閤ATO誘導及維持治療方案可以延長低中危APL患者的無複髮生存時間,併能降低低、中、高危患者的複髮率.
목적 탐토전반식유갑산(ATRA)연합삼양화이신(ATO)유도급유지치료방안대초진급성조유립세포백혈병(APL)적림상료효.방법 자2004년9월지2013년12월절강대학부속제일의원혈액과수치적298례초발APL환자,177례접수ATRA연합ATO치료,116례접수ATRA연합화료방안치료.회고성분석량충치료방안대저중위조(WBC≤10× 109/L)화고위조(WBC> 10×109/L)APL환자적림상료효.결과 재저중위APL환자중,ATRA연합화료화ARTA연합ATO유도급유지치료방안적복발솔분별위22.0%(20/91)화6.1% (6/98) (P=0.004);3년예계무복발생존(RFS)솔분별위78.0%화92.9%(P=0.021).재고위APL환자중,ATRA연합화료화ARTA연합ATO유도급유지치료방안적복발솔분별위25.0%(4/16)화5.2%(3/58) (P=0.035);3년예계RFS솔분별위80.8%화93.0%(P=0.063).량충방안치료적저중위화고위환자비교,조기병사솔、완전완해솔급총체생존솔차이무통계학의의(P>0.05).결론 ATRA연합ATO유도급유지치료방안가이연장저중위APL환자적무복발생존시간,병능강저저、중、고위환자적복발솔.
Objective To investigate the clinical efficacy of all-trans retinoic acid (ATRA) plus arsenic trioxide (ATO) in induction and maintenance therapy in newly diagnosed acute promyelocytic leukemia (APL).Methods A retrospective analysis of 298 newly diagnosed APL patients from the department of hematology,First Affiliated Hospital of Zhejiang University since September 2004 to December 2013,including 177 cases with ATRA plus ATO and 116 ATRA plus chemotherapy (CT),was performed to investigate the clinical efficacy between the low-intermediate (WBC≤1 0 × 109/L) and high (WBC > 10 × 109/L) risk APL patients,respectively.Results For the low-intermediate risk patients,the relapse rate in ATRA plus CT and ATRA plus ATO are 22.0% and 6.1% (P=0.004),respectively;the 3 years estimated relapse-free survival (RFS) are 78.0% and 92.9% (P=0.021),respectively.For the high risk patients,the relapse rate in ATRA plus CT and ATRA plus ATO are 25.0% and 5.2% (P=0.035),respectively;the 3 years estimated RFS rate were 80.8% and 93.0% (P=0.021),respectively.But the rate of early death (ED),complete remission (CR) and overall survival (OS) between the two therapy protocols had no statistical difference (P>0.05).Conclusions ATRA plus ATO in induction and maintenance therapy might prolong the RFS time of the low-intermediate risk APL patients and decrease the relapse rate of the low,intermediate and high risk APL patients.