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目的评价在诱导缓解治疗阶段应用柔红霉素、阿糖胞苷(DA方案)和全反式维甲酸(ATRA)双诱导治疗初诊高白细胞急性早幼粒细胞白血病(APL)的临床疗效及不良反应。方法回顾性分析2002～2011年深圳市人民医院收治的16例在诱导缓解治疗阶段均接受柔红霉素、阿糖胞苷和全反式维甲酸方案双诱导治疗的高白细胞急性早幼粒细胞白血病患者资料,对患者的临床缓解情况及治疗方案的不良反应进行分析。结果柔红霉素、阿糖胞苷联合全反式维甲酸方案双诱导治疗高白细胞急性早幼粒细胞白血病的临床完全缓解率达87.5%,1例死于肺部严重感染,1例死于颅内出血,3例患者出现维甲酸综合征且经治疗后好转。结论在诱导缓解阶段应用柔红霉素、阿糖胞苷联合全反式维甲酸方案双诱导治疗初诊高白细胞急性早幼粒细胞白血病完全缓解率高,不良反应少,是一种很好的治疗选择。
Objective To evaluate the clinical efficacy and adverse effects of dual induction of daunorubicin, cytarabine (DA) and all-trans retinoic acid (ATRA) in the treatment of newly diagnosed acute promyelocytic leukemia (APL) reaction. Methods A retrospective analysis of 16 patients admitted to Shenzhen People’s Hospital from 2002 to 2011 in the induction of remission were treated with dual induction of daunorubicin, cytarabine and all-trans retinoic acid regimen of high leukocyte acute promyelocytic Leukemia patient data, the patient’s clinical response and treatment of adverse reactions were analyzed. Results The complete remission rate of daunorubicin and cytarabine combined with all-trans retinoic acid regimen in the treatment of acute leukemia with acute promyelocytic leukemia was 87.5%, 1 patient died of serious pulmonary infection and 1 died of Intracranial hemorrhage, three patients with retinoic acid syndrome and improved after treatment. Conclusion It is a good treatment to treat newly diagnosed high promyelocytic acute promyelocytic leukemia with high response rate and less adverse reactions in the induced remission stage with dual induction of daunorubicin and cytarabine combined with all-trans retinoic acid regimen select.