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目的观察Ａｓ２Ｏ３治疗复发急性早幼粒细胞白血病疗效，以及外周血白细胞和骨髓象的动态改变与临床意义。方法复发急性早幼粒细胞白血病２８例，以Ａｓ２Ｏ３注射液１０ｍｇ／ｄ静脉滴注，治疗过程中每周或至评价疗效时进行骨髓检查，监测血常规及凝血纤溶指标和肝、肾功能、ＥＫＧ等变化。对达到完全缓解者进行随访。结果Ａｓ２Ｏ３注射液治疗２８例复发ＡＰＬ，完全缓解２７例。２０例治疗过程中出现白细胞增高（Ａ组），７例白细胞没有显著变化（Ｂ组）。Ａ组患者白细胞达高峰平均时间为９．４±２．９天，高峰持续时间平均为１０．８±４．８天。二组患者在治疗前白细胞计数没有显著差异（为２．５±１．４×１０９／Ｌ和３．８±１．７×１０９／Ｌ，Ｐ＝０．０５５７）。在整个治疗过程中，骨髓未出现增生受抑的情况。尽管有白细胞变化的不同，患者达完全缓解的时间无显著差异（为３２．４±６．５天和２７．６±３．０天，Ｐ＝０．０７５８）。无复发生存率也无显著差异（Ｐ＝０．０５７７）。在毒副反应中，以白细胞增益倍数高者出现的机会多。结论Ａｓ２Ｏ３注射液是治疗对全反式维甲酸治疗无效的急性早幼粒细胞白血病的有效药物，Ａｓ２Ｏ３注射液治疗并不能根除急性早幼粒细胞白血病的恶性?
Objective To observe the efficacy of As2O3 in the treatment of relapsed acute promyelocytic leukemia, as well as the dynamic changes and clinical significance of peripheral white blood cells and bone marrow. Methods 28 patients with relapsed acute promyelocytic leukemia were treated with intravenous injection of As2O3 10 mg/d. During the treatment period, bone marrow examination was performed every week or until the efficacy was evaluated. Blood routine, coagulation and fibrinolysis indicators, and liver and kidney function were monitored. EKG and other changes. Complete follow-up visits were completed. Results As2O3 injection was used to treat 28 cases of recurrent APL, and 27 cases were completely relieved. Elevated leukocytes (Group A) occurred in 20 patients and no significant changes in leukocytes were observed in 7 patients (Group B). The average peak time for white blood cells in group A was 9.4±2.9 days, and the average peak duration was 10.8±4.8 days. There was no significant difference in leukocyte counts before treatment between the two groups (2.5±1.4×109/L and 3.8±1.7×109/L, P=0.0557). During the entire course of treatment, no bone marrow hyperplasia was observed. Despite the difference in leukocyte changes, there was no significant difference in the time to complete remission in patients (32.4±6.5 days and 27.6±3.0 days, P=0.0758). There was no significant difference in recurrence-free survival (P = 0.0577). In poisonous side effects, there are many opportunities for people with high leukocyte gain multiples. Conclusion As2O3 injection is an effective drug for the treatment of acute promyelocytic leukemia ineffective for all-trans retinoic acid treatment. As2O3 injection can not eradicate the malignancy of acute promyelocytic leukemia.