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[急性早幼粒细胞白血病(APL)复发的急性早幼粒细胞白血病综合征(API)经三氧化二砷成功治疗后]

[Successful treatment after acute promyelocytic leukemia (APL) syndrome of relapsed API with arsenic trioxide].

作者信息

Hirayama Yasuo, Sakamaki Sumio, Takayanagi Norihiro, Tsuji Yasushi, Sagawa Tamotsu, Matsunaga Takuya, Niitsu Yoshiro

机构信息

Higashi Sapporo Hospital.

出版信息

Gan To Kagaku Ryoho. 2003 Mar;30(3):431-4.

Abstract

A 52-year-old female was diagnosed with relapsed APL in 2000. After obtaining informed consent, we administered 10 mg/day of arsenic trioxide intravenously. The complications were vomiting, increased transaminase and ATRA syndrome which included high fever, retention of body fluid, pleural effusion, pericardial effusion and respiratory failure from day 16. Administration of steroid and low dose chemotherapy (DNR 60 mg x day 1-2, BH-AC 250 mg x day 1-2) with arsenic was effective for APL syndrome, and complete remission (CR) was obtained at day 35 and PML-RAR mRNA became negative. After obtaining CR, consolidation chemotherapy was conducted and the patient was maintained the CR for more than 18 months. Although arsenic trioxide may be effective for relapsed APL, sufficient caution is needed because of the possibility of various complications.

摘要

一名52岁女性于2000年被诊断为复发的急性早幼粒细胞白血病(APL)。在获得知情同意后,我们静脉注射三氧化二砷,剂量为每日10毫克。并发症包括呕吐、转氨酶升高以及从第16天开始出现的维甲酸综合征,该综合征包括高热、体液潴留、胸腔积液、心包积液和呼吸衰竭。使用类固醇和低剂量化疗(柔红霉素60毫克×第1 - 2天,高三尖杉酯碱250毫克×第1 - 2天)联合三氧化二砷治疗APL综合征有效,患者在第35天获得完全缓解(CR),PML - RAR mRNA转为阴性。获得CR后,进行了巩固化疗,患者维持CR状态超过18个月。尽管三氧化二砷可能对复发的APL有效,但由于可能出现各种并发症,仍需充分谨慎。

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