摘要
目的探索急性早幼粒细胞白血病(APL)经全反式维甲酸(ATRA)治疗达完全缓解(CR)后理想的维持治疗方案,提高APL的长期无病生存时间。方法将我院21例初治的APL患者均经ATRA治疗达CR后,维持治疗方法为三氧化二砷(As2O3)、ATRA及6-巯基嘌呤(6-MP)加甲氨喋呤(MTX)序贯交替治疗3年;观察治疗的效果及不良反应,监测微小残留病。结果21例患者对上述治疗均有较好的顺从性,有11例患者维持治疗超过2年,无复发病例;PML/RARα融合基因初诊时均为阳性,12例持续转阴,其中维持治疗超过2年的11例患者均转阴;治疗相关的不良反应少见且较轻。结论用上述维持治疗经ATRA达CR的APL初步取得了令人满意的效果,其不良反应较传统的联合化疗轻,作者认为As2O3、ATRA与6-MP加MTX序贯交替治疗可能是APL理想的维持治疗方法。
Objective：To investigate the new maintenance chemotherapy of acute promyelocytic leukemia（APL） after complete remission by all-trans retinoic acid（ATRA）, thereby increasing the long disease-free survival time of APL. Method..21 newly diagnosed APL patients who achieved CR by ATRA administered a new maintenance chemotherapy method： to administer arsenic trioxide （As2O3 ）, ATRA and 6 - mercaptopurine （6-MP） ＋ methotrexate（MTX） alternately for 3 years to the patients. The efficacy and side effects of these chemotherapy were observed, and minimal residual disease（MRD） of the patients were monitored by RTPCR of PML/RARα. Result： All 21 APL patients had a high degree of compliance with these treatment. Up to now, all patients have being remained in CR1, and 11of 21 patients have being treated with maintenance chemotherapy over 2 years. The PML/ RARe fusion gene was positive in. all 21 patients when diagnosed. 12 of 21 patients who were monitored MRD turned to be negative continuously, and 11 of 12 were the patients who have being treated with maintenance chemotherapy over 2 years. The side effects of these two regimens were less and light. Conclusion：The preliminary efficacy of the chemotherapy which were used in 21 newly-diagnosed APL patients who gained CR after treatment of ATRA is satisfactory. The side effects is less than the combined chemotherapy. Maybe the maintenance chemotherapy method of alternate administration of As2O3 .ATRA and 6-MP＋MTX plays an important role in it.
出处
《临床血液学杂志》
CAS
2005年第6期331-333,共3页
Journal of Clinical Hematology
关键词
急性
白血病
早幼粒细胞性
维持化疗
Acute promyelocytic leukemia
Maintenance chemotherapy, As2O3
ATRA
6-MP＋MTX
