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目的探讨全反式维甲酸(ATRA)、三氧化二砷(As2O3)与化疗联合在急性早幼粒细胞白血病(APL)维持治疗中的疗效和不良反应。方法 52例APL患者经应用ATRA及As2O3诱导分化后完全缓解,用联合化疗方案巩固强化,以后开始维持治疗:第1个月,ATRA 25 mg/(m2.d)。第2个月,6-巯基嘌呤(6-MP)100 mg(每日1次),氨甲蝶呤(MTX)15 mg(每周1次)。第3个月,As2O30.16 mg/(kg.d),依次序贯治疗。观察该方案的远期疗效及不良反应。结果 52例患者持续缓解率(CCR)为88.5%,5 a预计OS和RFS分别为93.4%、87.6%,未发现严重不良反应。结论 APL完全缓解患者巩固强化治疗后用ATRA、As2O3与化疗联合维持治疗,总体生存率高,安全性好。
Objective To investigate the efficacy and adverse reactions of combined treatment of ATRA, As 2 O 3 and chemotherapy in the maintenance of acute promyelocytic leukemia (APL). Methods A total of 52 patients with APL were treated with ATRA and As2O3 to induce complete remission after differentiation. The combination chemotherapy was used to consolidate and intensify the therapy. After that, maintenance treatment was started: the first month, ATRA 25 mg / (m2.d). In the second month, 6- mercaptopurine (6-MP) 100 mg once daily and methotrexate 15 mg once weekly. The third month, As2O30.16 mg / (kg.d), followed by sequential treatment. To observe the long-term efficacy of the program and adverse reactions. Results The continuous response rate (CCR) of 52 patients was 88.5%. The estimated OS and RFS were 93.4% and 87.6% respectively after 5 years, and no serious adverse reactions were found. Conclusion ATRA, As2O3 and chemotherapy combined with maintenance therapy in patients with APL complete remission after consolidation and consolidation therapy have high overall survival rate and good safety.