Takitani K, Kawamura N, Yamaguchi H, Morinobu W, Yoshida N, Watanabe K, Miyake M, Tatsumi K, Mino M
Department of Pediatrics Osaka Medical College.
Rinsho Ketsueki. 1995 Feb;36(2):147-52.
We reported a 17-year-old girl with relapsed acute promyelocytic leukemia (APL) who achieved complete remission and has been received maintenance therapy with all-trans retinoic acid (ATRA). The patient was diagnosed as APL in 1986. The ANLL 861 protocol of the Children's Cancer and Leukemia Study Group induced complete remission, and the chemotherapy was discontinued in 1989. However, she suffered a relapse with APL in 1991 and begun receiving ATRA (30 mg/m2/day) therapy because of disseminated intravascular coagulation. Bleeding tendency was discontinued by day 5. During the treatment, the white blood cell count increased markedly to 35,510 per microliters on 15th day, however she achieved complete remission morphologically on day 18. After informed consent was obtained from the family, she has been given ATRA orally for more than three years at the time of this report. The pharmacokinetics examination (ATRA 20 mg/m2 single per os) was performed 12 and 22 months after the induction therapy. The each peak plasma level of ATRA was 89 and 149 ng/ml. The concentration of ATRA has yet reached a level despite the continuous ATRA therapy. We considered that it may be useful to monitor plasma levels of ATRA during the treatment.
我们报告了一名17岁复发急性早幼粒细胞白血病（APL）女孩，她已实现完全缓解，并一直接受全反式维甲酸（ATRA）维持治疗。该患者于1986年被诊断为APL。儿童癌症与白血病研究组的ANLL 861方案诱导其完全缓解，化疗于1989年停止。然而，她在1991年复发APL，因弥散性血管内凝血开始接受ATRA（30 mg/m²/天）治疗。出血倾向在第5天停止。治疗期间，第15天白细胞计数显著增加至每微升35,510，但她在第18天形态学上实现了完全缓解。在获得其家人的知情同意后，截至本报告时她已口服ATRA三年多。在诱导治疗后12个月和22个月进行了药代动力学检查（ATRA 20 mg/m²单次口服）。ATRA的各血浆峰值水平分别为89和149 ng/ml。尽管持续进行ATRA治疗，但ATRA浓度尚未达到某一水平。我们认为在治疗期间监测ATRA的血浆水平可能有用。
