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目的探讨初治中低危急性早幼粒细胞白血病(APL)患者诱导缓解治疗及完全缓解(CR)后的治疗方案。方法回顾性分析68例初治APL患者3种不同诱导治疗方法CR率、达CR所需时间及副作用,并分析CR后不同巩固治疗方案对预后的影响。结果全返式维甲酸(ATRA)联合蒽环类药物化疗、单用亚砷酸(AS2O3)及ATRA+AS2O3+化疗3种方法治疗初诊APL完全缓解率分别为90%、89%、89%,无显著差异,P>0.05;ATRA+AS2O3+化疗组达CR所需时间最短,ATRA+化疗组副作用最少,P<0.05;CR后选用ATRA、AS2O3、化疗序贯治疗能明显延长患者无病生存期。结论 ATRA+化疗方案可做为初治APL患者诱导缓解的首选方案;ATRA、AS2O3、化疗序贯治疗均可做为CR后的有效治疗方案,中低危患者可不必联用Ara-c化疗。
Objective To investigate the treatment of newly diagnosed mid-low-risk acute promyelocytic leukemia (APL) patients after induction remission and complete remission (CR). Methods Retrospective analysis of 68 cases of newly diagnosed APL patients with three different induction therapy CR rate CR time and side effects, and analysis of different consolidation after CR treatment on prognosis. Results The complete remission rates of all-trans retinoic acid (ATRA) combined with anthracycline chemotherapy, AS2O3 alone and ATRA + AS2O3 + chemotherapy were 90%, 89%, 89%, respectively ATRA + AS2O3 + chemotherapy group had the shortest CR, the least side effects in ATRA + chemotherapy group, P <0.05; ATRA and AS2O3 were selected after CR, and the sequential treatment with chemotherapy could prolong the disease-free survival of patients significantly. Conclusions ATRA + chemotherapy regimen can be the first choice of inducing remission in patients with newly diagnosed APL. ATRA, AS2O3 and sequential chemotherapy can be used as effective treatment after CR.