摘要
目的探讨三氧化二砷维持治疗对急性早幼粒细胞白血病(APL)患者远期复发率的影响。方法选取湖州市第一人民医院2011年12月至2013年12月收治的APL患者60例,根据随机数字表法将患者分为两组,各30例。所有患者接受相同的诱导治疗及巩固治疗。维持治疗期间给予对照组全反式维甲酸,观察组患者则使用三氧化二砷,维持治疗持续进行2个周期后,检测并比较两组患者血清相关水平变化情况及治疗期间不良反应发生情况;治疗后持续随访3年,记录并比较两组患者各年的复发率及生存率。结果维持治疗1个周期、2个周期,两组患者的总胆固醇、甘油三酯水平均较治疗前升高(均P<0.05),但观察组各血脂水平均低于对照组,差异均有统计学意义(t=2.044、2.175,均P<0.05)。观察组治疗期间维甲酸综合征、颅内压升高及其他不良反应发生率均低于对照组,差异均有统计学意义(6.67%比26.67%、6.67%比30.00%、6.67%比26.67%,χ^2=0.043、0.023、0.043,均P<0.05)。治疗后2、3年,观察组生存率高于对照组,差异均有统计学意义(90.00%比66.67%、83.33%比60.00%,χ^2=4.812、4.812,均P<0.05);治疗后3年,观察组复发率低于对照组,差异有统计学意义(10.00%比33.33%,χ^2=4.812,P<0.05)。结论急性早幼粒细胞白血病患者维持治疗阶段使用三氧化二砷对患者血脂代谢无明显影响,在一定程度上可减少患者不良反应发生,降低其复发率,提高其生存率。
Objective To explore the effect of arsenic trioxide maintenance therapy on the long-term recurrence rate in patients with acute promyelocytic leukemia (APL). Methods From December 2011 to December 2013, 60 patients with APL in the First People's Hospital of Huzhou were selected and divided into control group and observation group according to random number table, with 30 cases in each group.All patients received the same induction therapy and consolidation therapy.During the maintenance treatment period, all-trans retinoic acid (ATRA) was given to the control group, and arsenic trioxide was used in the observation group.The serum levels and incidence of adverse reactions in the two groups were detected and compared after two cycles of the maintenance therapy.Three years of follow-up was conducted after treatment to record and compare the recurrence rate and survival rate in the two groups. Results The levels of TC and TG after 1 and 2 cycles of treatment were higher than those before treatment in both two groups(all P<0.05), but the levels of lipid indicators in the observation group were lower than those in the control group, and the differences were statistically significant (t=2.044, 2.175, all P<0.05). The incidence rates of retinoic acid syndrome, elevated intracranial pressure and other adverse reactions in the observation group during the treatment were lower than those in the control group(6.67% vs.26.67%, 6.67% vs.30.00%, 6.67% vs.26.67%), and the differences were statistically significant(χ^2=0.043, 0.023, 0.043, all P<0.05). The survival rates after 2 and 3 years of treatment in the observation group were higher than those in the control group(90.00% vs.66.67%, 83.33% vs.60.00%), and the differences were statistically significant(χ^2=4.812, 4.812, all P<0.05). The recurrence rate after 3 years of treatment in the observation group was lower than that in the control group(10.00% vs.33.33%), and the difference was statistically significant(χ^2=4.812, P<0.05). Conclusion For patients with APL, the application of arsenic trioxide in the maintenance therapy can produce no significant effect on their lipid metabolism, and at a certain extent, can help reduce the incidence of adverse reactions and recurrence rate, and improve the survival rate.
作者
沈向理
张慧琪
黄静
杨宇佳
Shen Xiangli;Zhang Huiqi;Huang Jing;Yang Yujia(Department of Hematology,the First People's Hospital of Huzhou ,Huzhou ,Zhejiang 313000,China)
出处
《中国基层医药》
CAS
2019年第2期133-137,共5页
Chinese Journal of Primary Medicine and Pharmacy
关键词
白血病
早幼粒细胞
急性
三氧化二砷
阿糖胞苷
柔红霉素
复发
无病生存
出血
药物毒性
Leukemia, promyelocytic, acute
Arsenic trioxide
Cytarabine
Daunorubicin
Recurrence
Disease-free survival
Hemorrhage
Drug toxicity
