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目的观察亚砷酸(AS2O3),全反式维甲酸(ATRA)联合化疗方案序贯治疗成人急性早幼粒细胞白血病(APL)的疗效。方法 18例APL患者,采用ATRA及亚砷酸(出现高白细胞淤积症时,给予柔红霉素)联合进行诱导,巩固及维持治疗,并定期检测PML_RARa融合基因。结果完全缓解(CR)率为87.5%,达CR中位时间为26d,并于巩固治疗期间采用AS2O3与ATRA及蒽环类药物交替进行,并于以维持治疗,总疗程为3年。目前已12例停药,13例患者每3个月检测PML-RARa融合基因均为(-),3例处于维持治疗阶段。仅2例患者未达CR因脑出血死亡。结论 AS2O3与ATRA联合化疗治疗成人APL的疗效较满意。
Objective To observe the effect of sequential treatment of adult acute promyelocytic leukemia (APL) with arsenious acid (AS2O3) and all-trans retinoic acid (ATRA) combined with chemotherapy. Methods A total of 18 APL patients were treated with ATRA and arsenious acid (daunorubicin given with high leukocyte deposition) in combination with induction, consolidation and maintenance therapy. PML_RARa fusion gene was detected regularly. Results The complete remission (CR) rate was 87.5% and the median time to CR was 26 days. AS2O3 was used alternately with ATRA and anthracycline during the consolidation therapy to maintain the treatment for a total duration of 3 years. At present, 12 cases have been discontinued. PML-RARa fusion gene (-) was detected in 13 cases every 3 months and in maintenance treatment stage in 3 cases. Only 2 patients died less than CR due to cerebral hemorrhage. Conclusion AS2O3 and ATRA combined chemotherapy for the treatment of adult APL more satisfied.