[三氧化二砷与全反式维甲酸治疗急性早幼粒细胞白血病的疗效及不良反应比较]
[Comparison of efficacy and adverse effects between arsenic trioxide and all-trans retinoic acid in patients with acute promyelocytic leukemia].
作者信息
Jiao Li, Wang Shu-Jie, Zhuang Jun-Ling, Zhao Yong-Qiang, Zhou Dao-Bin, Xu Ying, Han Bing, Zhang Wei, Duan Ming-Hui, Zou Nong, Zhu Tie-Nan, Shen Ti
机构信息
Department of Hematology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.
出版信息
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2009 Oct;31(5):555-8.
OBJECTIVE
To compare the efficacy and adverse effects between arsenic trioxide (ATO) and all-trans retinoic acid (ATRA) in patients with acute promyelocytic leukemia (APL).
METHODS
The clinical data of 71 patients with newly diagnosed APL were retrospectively analyzed. Two groups were classified according to the induction regimens, namely ATO group (n = 41) and ATRA group (n = 30). The complete remission (CR) rate and the time to CR were compared between these two groups.
RESULTS
The CR rate was 97.5% in ATO group and 93.3% in ATRA group (P > 0.05). The median time to CR was 29 days (21-45 days) in ATO group, which was significantly shorter than 38.5 days (24-63 days) in ATRA group (P < 0.001). Retinoic acid syndrome occurred in 52.9% of patients treated with ATRA, which affected the further use of ATRA.
CONCLUSIONS
Both ATO and ATRA have high response rates for newly diagnosed patients with APL. Compared with ATRA, ATO induction therapy has shorter time to achieve CR and less adverse effects, and therefore may be the first-line therapy for APL.
目的
比较三氧化二砷（ATO）与全反式维甲酸（ATRA）治疗急性早幼粒细胞白血病（APL）患者的疗效及不良反应。
方法
回顾性分析71例新诊断APL患者的临床资料。根据诱导方案分为两组，即ATO组（n = 41）和ATRA组（n = 30）。比较两组的完全缓解（CR）率及达到CR的时间。
结果
ATO组CR率为97.5%，ATRA组为93.3%（P > 0.05）。ATO组达到CR的中位时间为29天（21 - 45天），明显短于ATRA组的38.5天（24 - 63天）（P < 0.001）。接受ATRA治疗的患者中52.9%发生维甲酸综合征，影响了ATRA的进一步使用。
结论
ATO和ATRA对新诊断的APL患者均有较高的缓解率。与ATRA相比，ATO诱导治疗达到CR的时间更短，不良反应更少，因此可能是APL的一线治疗方法。
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