摘要
目的了解急性早幼粒细胞白血病(APL)在诱导过程中的并发症及其As2O3副作用。方法回顾性分析62例初诊的APL患者的临床资料。结果在诱导期有18.2%的患者发生DIC,在全反式维A酸(ATRA)As2O3治疗过程中分别有57.1%、67.6%的患者发生白细胞增多症;As2O3治疗的患者中有18.9%发生了类似于维A酸综合征(RAS)反应的“亚砷酸综合征”。有40例患者初诊时WBC<10×109/L,其完全缓解(CR)率为72.5%,明显高于WBC>10×109/L者的CR率(45.5%)(P<0.05)。结论由于诱导分化剂的应用,APL治疗过程中DIC的发生率下降;As2O3在治疗APL时可引起白细胞增多症和“亚砷酸综合征”;初诊WBC>10×109/L的患者预后较差,WBC>10×109/L可视为“高白细胞”。
Objective To study the complication and the side-effect related to arsenic trioxide(As2O3) treatment during the remission induction in patients with newly diagnosed acute promyelocytic leukemia (APL). Methods The clinical information of 62 patients with newly diagnosed APL was retrospectively analyzed. Results 18.2 % patients occurred DIC and 10.7 % patients occurred intracranial hemorrhage during the remission induction. 67.6 % and 57.1% patients occurred leukocytosis respectively during the treatment with As2O3 and ATRA. 18.9 % of patients treated with As2O3 occurred arsenic trioxide syndrome which was similar to RAS. White blood cell (WBC) counts of 40 patients were less than 10×109/L when they were newly diagnosed. The complete remission(CR) rate of them was 72.5 %, which was higher evidently than one (45.5 %) of patients whose WBC counts were more than 10×109/L (P <0.05) . Conclusions The incidence of DIC during the treatment of APL decreases. As2O3 can result in arsenic trioxide syndrome and leukocytosis. A WBC of 10×109/L is an adverse prognostic features. WBC 10×109/L can be considered 'hyperleukocytosis'.
出处
《白血病．淋巴瘤》
CAS
2005年第3期158-161,共4页
Journal of Leukemia & Lymphoma
