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目的 :研究全反式维甲酸 (ATRA)治疗急性早幼粒细胞白血病 (APL)常见及少见毒副反应。方法 :回顾分析 38例APL在ATRA治疗期间出现的毒副反应。结果 :APL在ATRA治疗过程中常见毒副反应有不同程度的口干、皮肤干燥、脱屑、皲裂 (10 0 % ) ,19例出现胃肠道症状伴谷丙转氨酶增高 (5 0 % ) ,18例高白细胞综合征(47 5 % ) ,16例出现头痛、头晕 (42 4 % ) ,8例有肌肉、关节疼痛 (2 1 2 % )。少见毒副反应包括高颅压综合征 4 / 38,血糖升高 2 / 38,高组胺综合征 1/ 38等。结论 :ATRA治疗APL过程中常出现口干、皮肤干燥、脱屑、皲裂、胃肠道症状及高白细胞综合征等毒副反应。使用小剂量ATRA(2 0～ 30mg/日 ) ,可减少毒副反应的发生而对疗效无明显影响。
Objective: To study the common and rare toxic and side effects of all-trans retinoic acid (ATRA) in the treatment of acute promyelocytic leukemia (APL). Methods: Retrospective analysis of 38 cases of APL ATRA treatment occurred during the side effects. Results: The common side effects of APL were dry mouth, dry skin, desquamation and chapped (10%) during the course of ATRA treatment, 19 cases of gastrointestinal symptoms with elevated alanine aminotransferase (50%), 18 cases of high white blood cell syndrome (47.5%), 16 cases of headache, dizziness (42 4%), 8 cases of muscle and joint pain (21.2%). Rare toxic side effects include high intracranial pressure syndrome 4/38, elevated blood glucose 2/38, high histamine syndrome 1/38 and so on. Conclusion: ATRA often appears dry mouth, dry skin, scaling, chapped, gastrointestinal symptoms and high leukocyte syndrome in ATRA treatment. The use of small doses of ATRA (20 ~ 30mg / day), can reduce the incidence of adverse reactions without significant effect on the efficacy.