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目的 探讨三氧化二砷治疗复发难治性急性早幼粒细胞白血病 (APL)的疗效。方法 1988～ 2 0 0 0年 1月对 388例复发的APL给予三氧化二砷治疗 (10mg) ,连续用药至完全缓解。结果 应用三氧化二砷治疗的 388例复发APL中完全缓解 (CR)率为 74 13% ,部分缓解 (PR)率 10 14 % ,CR+PR为 84 2 7% ,预计 10年无病生存率为 6 9%。早期死亡率及治疗相关死亡率分别为 7%、 10 %。主要死亡原因是脑出血、DIC、脑梗死。本组高白细胞综合征发生率为 15 %。副作用主要是消化道症状 ,发生率为 2 6 % ,肝功能损害发生率为 9% ,肾功能损害 6 % ,心电图改变 16 % ,精神症状 7%。结论 临床研究表明三氧化二砷是治疗复发APL最有效的药物之一 ,并可治愈APL。
Objective To investigate the efficacy of arsenic trioxide in the treatment of relapsed and refractory acute promyelocytic leukemia (APL). Methods A total of 388 relapsed APL patients were treated with arsenic trioxide (10mg) from January 1988 to January 2000, and the drug was administered continuously until complete remission. Results Among 388 relapsed APL patients treated with arsenic trioxide, the complete remission (CR) rate was 74.13%, the partial remission (PR) rate was 10 14% and the CR + PR was 84 2 7%. The predicted 10-year disease-free survival rate was 6 9 %. Early mortality and treatment-related mortality were 7% and 10%, respectively. The main cause of death is cerebral hemorrhage, DIC, cerebral infarction. The incidence of high white blood cell syndrome in this group was 15%. Side effects are mainly gastrointestinal symptoms, the incidence was 26%, liver damage was 9%, renal damage 6%, ECG changes 16%, 7% of psychiatric symptoms. Conclusions Clinical studies show that arsenic trioxide is one of the most effective drugs in the treatment of recurrent APL and can cure APL.