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目的研究分析成人急性早幼粒细胞白血病(APL)应用化疗、全反式维甲酸(ATRA)和砷剂三联维持治疗的治疗效果。方法选择2007年2月至2009年2月我科收治的经过ATRA诱导缓解达完全缓解并采用联合化疗巩固治疗的APL患者48例,随即双盲的分成对照组和观察组各24例,对照组使用化疗及ATRA二联维持化疗,观察组使用化疗、ATRA和三氧化二砷三联维持化疗3年,比较两组持续完全缓解率及PML-RARα融合基因转阴率。结果对照组持续完全缓解率为66.7%,观察组持续完全缓解率为91.7%,两组比较差异具有统计学意义(P<0.05);对照组PML-RARα融合基因转阴率为62.5%,观察组PML-RARα融合基因转阴率为87.5%,两组比较差异具有统计学意义(P<0.05)。结论使用含有三氧化二砷的三联维持化疗,能够有效的降低患者的复发率、并且具有副反应少、安全性高的特点,是目前效果最显著的维持治疗方案,可推广使用。
Objective To study the therapeutic effect of triple therapy of adjuvant chemotherapy for acute promyelocytic leukemia (APL) in adults, all-trans retinoic acid (ATRA) and arsenic trioxide. Methods From February 2007 to February 2009, 48 patients with APL who underwent ATRA-induced remission and were treated with combination chemotherapy were enrolled in our department from January 2007 to February 2009, then divided into control group and observation group (24 cases), control group The patients in the observation group were treated with chemotherapy, ATRA and arsenic trioxide for 3 years. Chemotherapy and ATRA combined chemotherapy were used to maintain the chemotherapy. The sustained complete remission rate and PML-RARα fusion gene conversion rate in the two groups were compared. Results The sustained and complete remission rate was 66.7% in the control group and 91.7% in the observation group. The difference between the two groups was statistically significant (P <0.05). The negative rate of PML-RARα fusion gene in the control group was 62.5% Group PML-RARα fusion gene conversion rate was 87.5%, the difference between the two groups was statistically significant (P <0.05). Conclusions The use of triadimetric chemotherapy with arsenic trioxide can effectively reduce the recurrence rate of patients with less side effects and high safety. It is the most effective maintenance treatment and can be widely used.