Walker Deborah Kirk, Held-Warmkessel Jeanne
School of Nursing, University of Alabama at Birmingham, USA.
Clin J Oncol Nurs. 2010 Dec;14(6):747-59. doi: 10.1188/10.CJON.747-759.
Acute promyelocytic leukemia (APL), once described as the form of leukemia with the highest mortality, is now the most potentially curable subtype of adult acute myeloid leukemia. A brief review of the history of APL will describe the advances in research and clinical practice and their impact on patient outcomes. Oncology nurses should familiarize themselves with the nuances of APL because of the critical role nurses play in providing support for patients. This article provides an overview of APL, including the epidemiology and pathophysiology that distinguishes APL from other types of acute leukemia. Clinical presentation and diagnostic workup for patients suspected of having APL will be reviewed, as will the treatment course. Nursing implications and management will be provided related to potential treatment complications specific to APL, including coagulopathies, differentiation syndrome, and QT prolongation with the use of arsenic trioxide, as will the side effects and complications that can occur in any patient with leukemia, such as infection, hyperleukocytosis, tumor lysis, and increased intracranial pressure.
急性早幼粒细胞白血病（APL）曾被认为是死亡率最高的白血病类型，如今却是成人急性髓系白血病中最具潜在治愈可能的亚型。简要回顾APL的历史将展现研究及临床实践的进展及其对患者预后的影响。肿瘤专科护士应熟悉APL的细微差别，因为护士在为患者提供支持方面发挥着关键作用。本文概述了APL，包括将APL与其他类型急性白血病区分开来的流行病学和病理生理学。将对疑似患有APL患者的临床表现和诊断检查以及治疗过程进行回顾。还将提供与APL特有的潜在治疗并发症相关的护理要点和管理措施，包括凝血病、分化综合征以及使用三氧化二砷时的QT间期延长，以及白血病患者可能出现的副作用和并发症，如感染、白细胞增多症、肿瘤溶解和颅内压升高。
