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目的评价全反式维甲酸(all-trans retinoic acid,ATRA)联合三氧化二砷(arsenic trioxide,ATO)治疗急性早幼粒细胞白血病(acute promyelocytic leukemua,APL)的疗效。方法采用Meta分析方法,对近10年国内外有关比较ATRA联合ATO治疗与ATRA单独治疗APL疗效的随机对照试验文献(RCT),提取完全缓解率(CR)、复发率、病死率结局评价指标进行定量综合分析,估计合并OR值及其95%可信区间(95%CI)。结果共纳入6项RCT,共包括317例APL患者。Meta分析结果显示,ATRA联合ATO与ATRA单用治疗APL比较,CR、复发率差异有统计学意义,病死率结局指标差异无统计学意义(P﹥0.05),以上各结局指标的OR及其95%CI分别为2.24[1.22,4.14]、0.19[0.08,0.45]和0.41[0.15,1.14]。结论采用ATRA联合ATO治疗与ATRA单药治疗APL可提高CR,降低复发率。
Objective To evaluate the efficacy of all-trans retinoic acid (ATRA) combined with arsenic trioxide (ATO) in the treatment of acute promyelocytic leukemia (APL). Methods Meta-analysis was used to evaluate the CR rates of relapse rate and mortality in the recent 10 years from randomized controlled trials (RCTs) comparing the efficacy of ATRA with ATO and APT alone in the treatment of APL. A combined quantitative analysis estimated the combined OR and its 95% confidence interval (95% CI). Results A total of 6 RCTs were included, including 317 APL patients. The results of Meta analysis showed that there was significant difference between ATRA and ATRA alone in the treatment of APL. There was no significant difference in CR and recurrence rates between the ATRA and ATRA groups (P> 0.05). The OR of all above outcomes % CI were 2.24 [1.22,4.14], 0.19 [0.08,0.45] and 0.41 [0.15,1.14], respectively. Conclusions ATRA combined with ATO and ATRA alone can improve CR and reduce the recurrence rate.