摘要
目的:为明确三氧化二砷(亚砷酸,ATO)在初治和全反式维甲酸(all trans retinoicacid,AT RA)治疗后复发的急性早幼粒细胞白血病(acute promyelocyticleukemia,APL)的诱导缓解时,引起高白细胞血症(leukocytosis)和维甲酸综合征(reti noicacidsyndrome,RAS)的发生规律。方法:初治和复发的APL共30例,ATO10mg/d进行诱导缓解治疗。结果:30例患者中23例(77%)达到完全缓解,达到缓解平均时间37.1d。发生高白细胞血症有14例(47%),出现高白细胞血症平均时间为12.9d,发生高白细胞血症患者的白细胞平均基础值为3.1×109L-1,未发生高白细胞血症患者的白细胞平均基础值为2.6×109L-1,两者差异有统计学意义,z=-2.635,P=0.008,所有患者均未采用细胞毒药物治疗,白细胞均恢复至正常水平。RAS有9例(30%),发生RAS的平均时间为13.9d,发生RAS患者的白细胞平均基础值为3.6×109L-1,未发生RAS患者的白细胞平均基础值为2.6×109L-1,z=-1.909,P=0.046,无1例因RAS死亡。结论:ATO对初治和复发的APL诱导缓解安全有效,ATO诱导APL缓解时引起的高白细胞血症及RAS与白细胞基础水平有关,在诱导缓解过程中发生的RAS与高白细胞血症有一定相关性。高白细胞血症可以通过继续应用ATO逐渐恢复。
OBJECTIVE：To study the incidence of leukocytosic and the retinoic acid syndrome （RAS） in newly diagnosed and relapsed acute promyelocytic leukemia （APL） patients treated with ATO. METHODS： Thirty patients with newly diagnosed or relapsed APL were treated with ATO for remission induction at the dose of 10 mg/d. RESULTS： Twenty-three patients （77%） achieved complete remission, Mean time to remission was 37, 1 days. Leukocytosis was observed in 14 patients（47% ）, mean time to leukocytosis was 12. 9 days, median baseline leukocyte count for patients with leukocytosis was 3. 1 × 10^9 L^-1 , which was higher than that for patients who did not get leukocytosis （2.6 × 10^9 L^-1 , z= -2. 635, P=0. 008）. No other cytotoxic therapy was administered, and the leukocytosis resolved in all cases. The RA syndrome was observed in nine patients （30%）, mean time to RA syndrome was 13. 9 days, median baseline leukocyte count for patients with RA syndrome was 3. 6 × 10^9 L^-1 , which was higher than that for patients who did not get the RA syndrome （2. 6 × 10^9L^-1 , z=-1. 909, P=0. 046）. Patients who get leukocytosis were significantly more likely to worsen the RA syndrome, and no patient died of the RA syndrome. CONCLUSIONS： ATO is a safe and highly effective agent for inducing complete remissions in patients with newly diagnosed and relapsed APL. Leukocytosis and the RA syndrome are associated with ATO and with baseline leukocyte count, and there is distinct link between the two phenomena. Leukocytosis regresses with continued ATO treatment alone.
出处
《中华肿瘤防治杂志》
CAS
2006年第8期614-617,共4页
Chinese Journal of Cancer Prevention and Treatment
