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目的比较急性早幼粒细胞白血病(APL)缓解后采用不同治疗方案对长期生存的影响。方法回顾性采用缓解后不同治疗方案的111例 APL 患者的长期生存情况。第1组:全反式维甲酸(ATRA)、三氧化二砷(As_2O_3)、化疗序贯治疗组40例;第2组:ATRA、化疗交替治疗组30例;第3组:As_2O_3、化疗交替治疗组26例;第4组:单纯化疗组15例。随访中位时间32(6～185)个月。结果随访截止时,有85例患者无病生存,18例死亡,8例失访。4组存活分别为(36/40、23/30、21/26、5/15)例;死亡(3/40、5/30、5/26、5/15)例;4组存活≥3年者分别为(16/40、12/30、11/26、1/15)例。111例患者预计5年总体生存率(OS)为(78.3±4.9)%,5年无复发生存率(RFS)为(76.9±5.1)%。治疗中有21例复发。结论 APL 患者缓解后接受联合治疗比单纯化疗具有更好的 OS 和RFS。ATRA、As_2O_3、化疗的序贯治疗方案对长期生存最有利。
Objective To compare the long-term survival of acute promyelocytic leukemia (APL) treated with different treatment regimens. Methods The long-term survival of 111 APL patients with different treatment regimens was retrospectively reviewed. Group 1: ATRA, As2O3, 40 cases of sequential treatment with chemotherapy; Group 2: ATRA, 30 cases of alternating treatment with chemotherapy; Group 3: As2O3, alternating treatment with chemotherapy group 26 Cases; Group 4: chemotherapy alone in 15 cases. Follow-up median time 32 (6 ~ 185) months. Results At the end of follow-up, 85 patients were disease-free, 18 died and 8 lost. The survival rates of the four groups were (36/40, 23/30, 21/26, and 5/15) respectively; the death rate was 3/40, 5/30, 5/26, and 5/15; Were (16/40, 12/30, 11/26, 1/15) respectively. The overall survival at 5 years was (78.3 ± 4.9%) of 111 patients and (76.9 ± 5.1)% at 5 years. There were 21 recurrent cases in the treatment. Conclusions APL patients receiving combined treatment after remission have better OS and RFS than those with chemotherapy alone. ATRA, As 2 O 3, sequential chemotherapy regimens are most beneficial to long-term survival.