CAJ | 학술논문

目的：评价不同方案治疗急性早幼粒细胞白血病（acute promyelocytic leukemia，APL）的近期及远期疗效。方法回顾本院2004年1月至2010年1月收治的200例APL患者，按照不同诱导缓解治疗方案分为化疗组、维A酸组和三氧化二砷（arsenic trioxide，ATO）组。通过比较三组患者完全缓解（complete remission，CR）率以及获得CR所需时间、不良反应发生率等，评价三种治疗方案的近期疗效。通过比较三组患者5年总生存率、复发率，评价三种治疗方案的远期疗效。结果维A酸组与ATO组患者CR均优于化疗组（P＜0.05），患者获得CR所需时间均短于化疗组（P＜0.05）。化疗组患者普遍出现口干头痛，部分患者存在骨髓抑制、皮疹等不良反应；维A酸组患者不良反应以高白细胞血症为主，同时出现维A酸综合征；ATO组患者出现肝功能异常、转氨酶升高。化疗组患者复发率高于维A酸组和ATO组（P＜0.05），5年总生存率低于维A酸组和ATO组（P＜0.05），维A酸组与ATO组比较并无显著差异（P＞0.05）。结论维A酸联合化疗药物或ATO均能够获得较好的远期及近期疗效。
목적：평개불동방안치료급성조유립세포백혈병（acute promyelocytic leukemia，APL）적근기급원기료효。방법회고본원2004년1월지2010년1월수치적200례APL환자，안조불동유도완해치료방안분위화료조、유A산조화삼양화이신（arsenic trioxide，ATO）조。통과비교삼조환자완전완해（complete remission，CR）솔이급획득CR소수시간、불량반응발생솔등，평개삼충치료방안적근기료효。통과비교삼조환자5년총생존솔、복발솔，평개삼충치료방안적원기료효。결과유A산조여ATO조환자CR균우우화료조（P＜0.05），환자획득CR소수시간균단우화료조（P＜0.05）。화료조환자보편출현구간두통，부분환자존재골수억제、피진등불량반응；유A산조환자불량반응이고백세포혈증위주，동시출현유A산종합정；ATO조환자출현간공능이상、전안매승고。화료조환자복발솔고우유A산조화ATO조（P＜0.05），5년총생존솔저우유A산조화ATO조（P＜0.05），유A산조여ATO조비교병무현저차이（P＞0.05）。결론유A산연합화료약물혹ATO균능구획득교호적원기급근기료효。
ObjectiveTo investigate the short-term and long-term efifcacy of different treatment on the patients with acute promyelocytic leukemia (APL) .Method200 cases of patients from January 2004 to January 2010 in our hospital were divided into chemotherapy group, tretinoin group and arsenic trioxide (ATO) group. By comparing the rate of complete remission (CR) and obtain the CR required time, incidence of adverse reactions to evaluated the short-term and long-term follow-up results of three treatment regimens. ResultCR rate of patients in tretinoin group and ATO group were lower than chemotherapy group and the time of treatment were shorter than chemotherapy group. The main adverse reactions of tretinoin group were high blood leukocytes, followed by retinoic acid syndrome, and the main adverse reactions of ATO group were abnormal liver function and transaminase lifts. The recurrence rate of patients in chemotherapy group were higher than tretinoin group and ATO group (P<0.05), 5 years survival rate was lower than tretinoin group and ATO group (P<0.05), but there was no signiifcant difference between tretinoin group and ATO group (P>0.05).ConclusionTretinoin combined with chemotherapeutics or ATO can obtain better long-term and short-term follow-up results.