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目的观察全反式维甲酸(ATRA)联合高三尖杉酯碱(HHT)治疗初发急性早幼粒细胞白血病(APL)的疗效和生存情况。方法 ATRA联合HHT治疗初治APL患者75例,观察患者临床特征、疗效及生存情况。结果 58例患者获得完全缓解(CR),CR率77.3%;17例患者诱导失败,其中16例死于诱导治疗早期。在平均36个月的中位随访时间中,分别有2例和3例患者死于巩固和维持治疗阶段。患者预期3年总生存率为71.5%,3年无事件生存率为61.0%,获得CR患者3年无事件生存率为78.9%。结论 ATRA联合HHT治疗初发APL患者疗效好,长期生存率高,且价格经济,是APL治疗的合理选择之一。
Objective To investigate the efficacy and survival of all-trans retinoic acid (ATRA) combined with homoharringtonine (HHT) in the treatment of initial acute promyelocytic leukemia (APL). Methods 75 cases of newly diagnosed APL patients were treated with ATRA combined with HHT. The clinical features, efficacy and survival of the patients were observed. Results 58 patients achieved complete remission (CR), CR rate was 77.3%; 17 patients failed to induce, of which 16 died of early induction therapy. During a median follow-up of 36 months, two and three patients, respectively, died of consolidation and maintenance treatment. Patients expected a 3-year overall survival of 71.5%, a 3-year event-free survival rate of 61.0%, and a 3-year event-free survival rate of 78.9% for patients with CR. Conclusion ATRA combined with HHT treatment of APL patients with initial treatment effect, long-term survival rate, and the price of the economy is one of the reasonable choice of APL treatment.