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对38例急性早幼粒细胞白血病(APL)患者经全反式维甲酸(ATRA)诱导分化治疗后,观察外周血及骨髓细胞形态学的改变及其与预后的关系。方法:(1)对每例患者初诊及每次化疗前后外周血及骨髓细胞形态学进行观察;(2)治疗一般用ATRA60～80mg/d。结果完全缓解(CR)率73.6％;治疗中APL细胞有明显成熟分化表现者易达CR且不易复发;4例部分缓解(PR)病人及未缓解者成熟分化改变不明显,有一定判断预后意义;CR过程中外周血出现幼粒细胞提示有复发可能;经ATRA诱导2例见有骨髓抑制。
After 38 cases of acute promyelocytic leukemia (APL) were treated with all-trans retinoic acid (ATRA) differentiation, the morphological changes of peripheral blood and bone marrow cells and their relationship with prognosis were observed. Methods: (1) To observe the morphology of peripheral blood and bone marrow cells before and after each treatment in each patient; (2) ATRA 60-80 mg/d is generally used for treatment. Results The complete remission (CR) rate was 73.6%. The patients with apparent mature differentiation of APL cells were easy to reach CR and difficult to relapse. The changes of maturation and differentiation of 4 patients with partial remission (PR) and non-remission were not obvious, and had certain prognostic significance. During the CR process, the appearance of myelocytes in the peripheral blood suggested a possible recurrence; two cases of myelosuppression were induced by ATRA.