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目的:观察三联疗法治疗急性早幼粒性白血病(acute promylocytic leukemia,APL)的疗效。方法:治疗组采用三联疗法(维甲酸、亚砷酸(AS2O3)、小剂量化疗)进行APL初发病时治疗;对照组采用常规化疗法进行初发病时治疗,两组均进行序贯疗法治疗APL。结果:治疗组白细胞开始下降时间为6.8±1.4 d,对照组为12.3±2.3 d;嗜天青颗粒开始减少时间为8.9±2.1 d,对照组为15.5±3.6 d;细胞核分裂分化加速时间为10.7±2.3 d,对照组为18.9±3.8 d;凝血指标恢复正常时间为12.8±3.1 d,对照组为21.2±4.4 d;骨髓缓解时间为15.1±1.9 d,对照组为31.2±3.3 d;两组间比较有差异性。经过用三联疗法治疗后,治疗组化疗后反应和并发症较对照组明显减少,感染率也明显下降。治疗组完全缓解(CR)88.2%,无1例死亡;对照组完全缓解33.3%,3例合并脑出血死亡。结论:用维甲酸、亚砷酸、HAC小剂量化疗三联疗法治疗APL较一般方法疗效显著,而且能缩短达CR的时间,降低死亡率。
Objective: To observe the efficacy of triple therapy in the treatment of acute promylocytic leukemia (APL). Methods: The treatment group was treated with triple therapy (retinoic acid, arsenic trioxide (AS2O3), low-dose chemotherapy) at the initial onset of APL. The control group was treated with initial chemotherapy by conventional chemotherapy. Both groups were treated with sequential therapy . Results: In the treatment group, the leukopenia time was 6.8 ± 1.4 days and that in the control group was 12.3 ± 2.3 days. The descent time of aztreonam was 8.9 ± 2.1 days and that in the control group was 15.5 ± 3.6 days. The mitotic differentiation time was 10.7 ± 2.3 d in the control group and 18.9 ± 3.8 d in the control group. The recovery time of the coagulation index was 12.8 ± 3.1 days in the control group and 21.2 ± 4.4 days in the control group. The time for bone marrow remission was 15.1 ± 1.9 days and 31.2 ± 3.3 days in the control group. Between more differences. After treatment with triple therapy, the treatment group after chemotherapy response and complications significantly reduced compared with the control group, the infection rate was significantly decreased. The treatment group, complete remission (CR) 88.2%, no one death; the control group completely relieved 33.3%, 3 patients died of cerebral hemorrhage. Conclusion: Treating APL with retinoic acid, arsenious acid and HAC in low dose chemotherapy is more effective than the common method and can shorten the time of CR and reduce the mortality rate.