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为了解用全反式维甲酸(ATRA)治疗急性早幼粒细胞白血病(APL)过程中高白细胞血症发生情况并探讨白细胞数的高低对ATRA治疗效果的影响,本研究根据患者外周血白细胞数量的多少,将其分为白细胞数<30×109/L单用ATRA诱导治疗组、白细胞>30×109/L单用ATRA治疗组及白细胞>30×109/L用ATRA和化疗相结合治疗组,以观察疗效。结果表明:39例APL病人在用ATRA治疗过程中23例出现高白细胞血症,高白细胞血症发生率为58.97%。单用ATRA及ATRA+化疗的总缓解率为91.3%。其中外周血白细胞数<30×109/L而单用ATRA治疗组缓解率为100%,血白细胞数>30×109/L而单用ATRA治疗组缓解率为87.5%,血白细胞数>30×109/L而用ATRA+化疗组的组缓解率为90.9%。结论:ATRA与化疗相结合,可有效控制ATRA治疗期间出现的高白细胞血症,降低早期病死率。
(ATRA) in the treatment of acute promyelocytic leukemia (APL) in the process of high leucocytosis and explore the level of white blood cells on the ATRA treatment effect, this study based on the number of patients with peripheral blood leukocytes The number of white blood cells was divided into 30 × 109 / L ATRA alone treatment group, white blood cells> 30 × 109 / L ATRA alone treatment group and white blood cells> 30 × 109 / L with ATRA and chemotherapy combined treatment group, To observe the effect. The results showed that: 39 cases of APL patients treated with ATRA in 23 cases of hypervolemia, high incidence of leukemia was 58.97%. The overall response rate with ATRA alone and ATRA + chemotherapy was 91.3%. The number of leukocytes in peripheral blood was less than 30 × 109 / L and the remission rate was 100% in ATRA alone group, the number of white blood cells was 30 × 109 / L, while the remission rate was 87.5% and the number of white blood cells> 30 × 109 / L and ATRA + chemotherapy group, the remission rate was 90.9%. Conclusion: The combination of ATRA and chemotherapy can effectively control the high leucocytosis that occurs during ATRA treatment and reduce the early mortality rate.