伊达比星为主的分层治疗方案对急性早幼粒细胞白血病的疗效分析

发布时间：2018-03-19 21:30

本文选题：急性早幼粒白血病　切入点：全反式维甲酸　出处：《中国实验血液学杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的:探讨全反式维甲酸(all-transretinoic acid,ATRA)联合亚砷酸(arsenious acid,ATO)双诱导治疗急性早幼粒细胞白血病(acute promyelocytic leukemia,APL)的缓解率和伊达比星、全反式维甲酸、亚砷酸/复方黄黛片分层序贯巩固治疗的疗效。方法:收集2010年至2016年接受双诱导方案患者22例,分析双诱导的CR率、早期死亡率、并发症发生率和获得完全缓解的时间长短。完全缓解后低、中危患者接受1-2个疗程IDA单药化疗,ATRA和复方黄黛片/ATO交替治疗4个周期;高危患者接受IA化疗4疗程,ATRA和复方黄黛片/ATO交替治疗共4个周期。结果:双诱导完全缓解率100%,诱导治疗平均时间28.23±1.6 d,诱导期间50%发生感染,36.4%出现分化综合征,27.3%有不同部位出血。完全缓解后分层巩固治疗组5年总生存率100%,无复发生存95.4%;结论:APL患者接受ATRA和ATO双诱导治疗能够达到较高缓解率,诱导缓解时间短,并发症可控。采用IDA、ATRA和ATO分层序贯治疗作为缓解后巩固方案,能够降低复发率,延长患者的生存期,获得极高的治愈率。
[Abstract]:Objective: to investigate the remission rate of all-trans retinoic acid (ATRAA) combined with arsenious acido (ATO) in the treatment of acute promyelocytic leukemia (AHL), and to evaluate the efficacy of ATRA-ATRA-ATRA-ATRA-ATRA-ATRA-ATO in the treatment of acute promyelocytic leukemia (AAPL) and in the treatment of acute promyelocytic leukemia (AHL). Methods: from 2010 to 2016, 22 patients who received double induction regimen were collected, and the rate of CR and early mortality were analyzed. The incidence of complications and the duration of complete remission were low after complete remission. Patients at moderate risk received 1-2 courses of IDA single drug chemotherapy and compound Huangdai tablets / ATO alternately for 4 cycles. Results: the complete remission rate of double induction was 100, the average time of induction treatment was 28.23 卤1.6 days, and the incidence of infection during induction was 36.4% and differentiation syndrome was 27.3%. After complete remission, the 5-year overall survival rate was 100%, and the survival rate was 95.4%. Conclusion both ATRA and ATO can achieve a higher remission rate in patients with ATRA and ATO. The induction and remission time is short and the complications are controllable. The treatment of IDAA-ATRA and ATO can reduce the recurrence rate prolong the survival time and obtain a very high cure rate.
【作者单位】：解放军总医院血液科;
【分类号】：R733.71

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