Chen Li, Wang Jianmin, Hu Xiaoxia, Xu Xiaoqian
Hematology. 2014 Jun;19(4):202-7. doi: 10.1179/1607845413Y.0000000118. Epub 2013 Nov 25.
To explore the combination therapy of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO, As2O3) on acute promyelocytic leukemia (APL).
A meta-analysis of six studies was performed. Among 415 included cases, 165 cases were in the ATRA + ATO group, 129 cases in the ATRA-alone group, and 121 cases in the ATO-alone group. The complete remission (CR) rate and incidences of three groups were compared, respectively, between the therapies of ATRA + ATO with ATRA-alone, ATRA + ATO with ATO-alone, and ATRA with ATO.
The assessment results showed that ATRA + ATO therapy significantly improved the CR rate and decreased the incidences of cutaneous reaction compared with ATRA-alone (P < 0.05). However, incidence of liver injury was higher in the ATRA + ATO and ATO-alone groups than that in ATRA-alone group (P < 0.05). Difference in the complications between ATRA + ATO therapy and ATO-alone was not significant (P > 0.05).
In conclusion, we suggest low-dose ATRA and ATO combination therapy may be more effective for the treatment of APL.
探讨全反式维甲酸（ATRA）与三氧化二砷（ATO，As2O3）联合治疗急性早幼粒细胞白血病（APL）的效果。
对六项研究进行荟萃分析。纳入的415例病例中，165例在ATRA + ATO组，129例在单纯ATRA组，121例在单纯ATO组。分别比较了ATRA + ATO与单纯ATRA、ATRA + ATO与单纯ATO以及ATRA与ATO治疗之间三组的完全缓解（CR）率和发生率。
评估结果显示，与单纯ATRA相比，ATRA + ATO治疗显著提高了CR率并降低了皮肤反应的发生率（P < 0.05）。然而，ATRA + ATO组和单纯ATO组的肝损伤发生率高于单纯ATRA组（P < 0.05）。ATRA + ATO治疗与单纯ATO治疗之间并发症的差异不显著（P > 0.05）。
总之，我们建议低剂量ATRA与ATO联合治疗可能对APL的治疗更有效。
