摘要
目的观察高三尖杉酯碱（HHT）联合全反式维甲酸（ATRA）和三氧化二砷（As2O3）治疗初治急性早幼粒细胞白血病（APL）的临床疗效、诱导治疗期不良反应及治疗费用。方法回顾性分析HHT联合ATRA和As2O3方案（观察组）、去甲氧柔红霉素（IDA）联合ATRA和As2O3，方案（对照组）治疗初治APL的临床资料，其中观察组14例，对照组21例，比较两组临床疗效、诱导治疗期不良反应及治疗费用。结果①观察组和对照组CR率分别为92．9％（14例中13例）、95．2％（21例中20例），获得CR的时间分别为（28．1±3．8）、（31．7±4．2）d；诱导缓解后观察组和对照组PML—RARα融合基因阴性率分别为76．9％（13例中10例）、75．O％（20例中15例）；CR患者序贯治疗第1周期结束后PML—RARc~融合基因阴性率分别为100．0％和95．0％，差异均无统计学意义（P〉0．05）。②观察组和对照组5年总生存（0s）率分别为（92．6±0．6）％、（89．9±0．5）％；5年无病生存（DFS）率分别为100．O％、（86．8±0．6）％，差异均无统计学意义（P〉0．05）。⑧诱导治疗期间，观察组和对照组感染发生率分别为23．1％和60．0％；机采血小板输注量分别为（54．7±29．6）、（76．5±25．6）U；新鲜冰冻血浆输注量分别为（1157．1±238．4）、（1423．5-4-324．6）ml；剔除HHT和IDA费用后，总的医疗费用分别为（36074．9±1245．6）、（50564．5±3658．4）元，差异均有统计学意义（P〈0．05）。结论HHT联合ATRA和As2O3治疗初发APL患者疗效好，长期生存率高，且费用低，是APL治疗的合理选择之一。
Objective To study the clinical outcome, adverse effect and treatment cost of homohar- ringtonine（HHT） in combination with all-trans retinoie acid（ATRA） and arsenic trioxide（ AS2O3 ） for newly diagnosed with patients acute promyeloeytic leukemia （APL）. Methods Clinical data of treatment of newly diagnosed patients with APL in experimental group （ HHT ＋ ATRA ＋ AS2 03 , n - 14 ） and control group [ Idaru- bicine（IDA） ＋ ATRA ＋ AS：O3 , n = 21 ] were analyzed retrospectively. The therapeutic effects, side effects and costs during induction therapy were compared between the two groups. Results ①The complete remis- sion（ CR）rate were 92.9% （13/14） and 95.2% （20/21） in experimental group and control group, respec- tively. The time to achieve CR were （28.1 ± 3.8 ） and （31.7± 4.2） days, respectively （ P 〉 0.05 ）. The negative rate of PML-RARα fusion gene at the time of CR were 76.9% （ 10/13 ） and 75.0% （ 15/20）, re- spectively, and that in CR patient at the end of the first cycle treatment were 100.0% （13/13） and 95.0% （ 19/20 ）, respectively （ P 〉 0. 05 ）. ②5-year overall survival （OS） rate were （ 92.6 ± 0.6 ） % and （ 89.9 ＋ 0.5 ） % , respectively （ P 〉 0.05 ） , 5-year disease free survival （ DFS ） rate were 100. 0% and （ 86.8 ± 0. 6） % , respectively （ P 〉 0. 05 ）. ③During induction therapy, the incidence of infection in experimental and control group were 23.1% （ 3/13 ） , 60.0% （ 12/20）, respectively （ P 〈 0.05 ）. The amount of platelet trans- fusion were （54.7 ± 29.6 ） and （ 76.5 ± 25.6 ） units, respectively （ P 〉 0.05 ） , and that of fresh frozen plasma were （ 1157.1 ± 238.4） and （ 1423.5 ± 324.6） ml, respectively（ P 〉 0.05 ）. The total medical costs （excluding HHT and IDA） in experimental and control group were （36074.9 ± 1245.6）and（50564.5 ± 3658.4） CNY, respectively （P 〈 0.05 ）. Conclusion HHT in combination with ATRA and AS2 03 regimen for newly diagnosed APL has a better efficacy, a higher long-term survival rate, and a lower costs, which is one of the reasonable choice.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2013年第2期144-148,共5页
Chinese Journal of Hematology
基金
浙江省宁波市农业与社会发展科技计划项目（2008-2-22）
