全反式维甲酸联合三氧化二砷治疗成人急性早幼粒细胞白血病的效果

全反式维甲酸联合三氧化二砷治疗成人急性早幼粒细胞白

血病的效果

[摘要] 目的探讨全反式维甲酸（ATRA）联合三氧化二砷治疗成人急性早幼粒细胞白血病的效果。方法选取本院2009年1月～2014年1月收治的57例急性早幼粒细胞白血病患者作为研究对象，随机分成观察组（27例）与对照组（30例）。观察组采用ATRA联合三氧化二砷进行治疗，对照组单纯采用ATRA进行治疗。比较两组的治疗效果及相关不良反应发生率。结果两组的PML-RARα融合基因转阴率比较，差异无统计学意义（P>0.05）。观察组的达到CR时间显著短于对照组，CR率显著高于对照组，白细胞峰值显著小于对照组，差异有统计学意义（P<0.05）。观察组的不良反应发生率显著低于对照组，差异有统计学意义（P<0.05）。所有患者随访1年，观察组的无病生存率显著高于对照组，复发率显著低于对照组，差异有统计学意义（P<0.05）。结论ATRA联合三氧化二砷治疗成人急性早幼粒细胞白血病效果显著，可以缩短CR时间，提高缓解率，且不良反应发生率与复发率较低，值得临床推广应用。

[关键词] 全反式维甲酸；三氧化二砷；成人；急性早幼粒细胞白血病

[中图分类号] R557+.3 [文献标识码] A [文章编号]

1674-4721（2016）03（c）-0081-03

[Abstract] Objective To explore the effect of all trans retinoic acid combined with arsenic trioxide in the treatment of acute promyelocytic leukemia. Methods 57 cases of acute promyelocytic leukemia from January 2009 to January 2014 in our hospital were selected and randomly divided into the observation group （27 cases）and the control group （30 cases）.The observation group was treated with all trans retinoic acid combined with arsenic trioxide，the control group was treated with all trans retinoic acid.The therapeutic effect and

the incidence rate of adverse reaction in the two groups was compared. Results There was no significant difference in the negative rate of PML-RAR alpha fusion gene between two groups （P>0.05）.The time of achieving CR in the observation group was shorter than that in the control group，the CR rate of the observation group was higher than that in the control group，the peak value of white blood cell in the observation group was less than that in the control group，with significant different

（P<0.05）.The incidence rate of adverse reaction in the observation group was lower than that in the control group，with significant different （P<0.05）.All patients were followed

up for 1 years，no disease survival rate in the observation group was higher than that in the control group，the recurrence rate in the observation group was lower than that in the control group，with significant different （P<0.05）. Conclusion The effect of all trans retinoic acid combined with arsenic trioxide in the treatment of acute promyelocytic leukemia is significant，which can shorten the time of CR and improve the response rate，and the incidence rate of adverse reaction and recurrence rate is low，it is worthy of clinical promotion and application.

[Key words] All trans retinoic acid；Arsenic trioxide；Adult；Acute promyelocytic leukemia

急性早幼粒细胞白血病（acute promyelocytic leu-kemia，APL）起病较急，部分患者在血液学完全缓解（CR）前期死于并发症，其为第一种通过靶向治疗成功的急性白血病（acute myeloblastic leukemia，AML）亚型，CR后的预后情况较好，能够明显延长患者的生存年限[1-2]。本病临床上常采用全反式维甲酸（all trans retinoic acid，ATRA）进行治疗，能够取得令人满意的疗效，但是复发率较高。若单独采用ATRA与三氧化二砷进行治疗，虽然能够在很大程度上改善APL的病情，但其达到CR的时间需要提高45 d左右，这给患者的病情控制带来一定影响，因此如何快速降低其复发率和不良反应发生率成为临床医务人员研究的重点课题[3-4]。