a Department of Hematology , The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University , Huai'an , P. R. China.
b Key Laboratory of Hematology of Nanjing Medical University , Nanjing , China.
Leuk Lymphoma. 2019 Mar;60(3):711-719. doi: 10.1080/10428194.2018.1504941. Epub 2018 Nov 8.
The specific prognostic factors and the long-term effects of different treatment options in APL remain unclear. In this retrospective study, 70 APL patients were treated with ATRA + DNR/DA or ATRA + ATO regimens for induction therapy and DA or ATRA + ATO for consolidation and maintenance therapy. The prognostic factors and treatment effects on outcome were analyzed. Results showed that the 5-year OS in low-intermediate risk and high risk groups were 95.63% and 100%, and the 5-year RFS were 95.34% and 100%, respectively, the early mortality rate was 4.28%. No significant difference was found on OS and RFS with different regimens, but side-effects and treatment-related mortality rates were lower in ATRA + ATO group. CD34 expression, FLT3-ITD mutation and PML-RARA isoform had no significance on OS and RFS. In conclusion, cytogenetic and molecular abnormalities had no influence on effect of APL patients; ATRA + ATO sequential maintenance may alleviate complications, treatment-related mortality, and the previously high risk factors.
APL 中不同治疗方案的具体预后因素和长期疗效仍不清楚。在这项回顾性研究中，70 例 APL 患者接受 ATRA+DNR/DA 或 ATRA+ATO 方案诱导治疗，以及 DA 或 ATRA+ATO 方案巩固和维持治疗。分析了预后因素和治疗对结局的影响。结果显示，低中危组和高危组的 5 年 OS 分别为 95.63%和 100%，5 年 RFS 分别为 95.34%和 100%，早期死亡率为 4.28%。不同方案在 OS 和 RFS 上无显著差异，但 ATRA+ATO 组的副作用和治疗相关死亡率较低。CD34 表达、FLT3-ITD 突变和 PML-RARA 异构体对 OS 和 RFS 无显著影响。总之，细胞遗传学和分子异常对 APL 患者的疗效无影响；ATR A+ATO 序贯维持可能减轻并发症、治疗相关死亡率和先前的高危因素。
