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全反式维甲酸联合亚砷酸对NPM1阳性老年非早幼粒细胞急性髓细胞白血病患者的疗效分析
肖蓉,姜涛,万纯黔,李慧,李成龙,车菲菲,陈姣,黄晓兵,王春森,王晓冬
0
(四川省医学科学院·四川省人民医院血液科)
摘要:
【摘要】 目的 研究全反式维甲酸(ATRA)联合亚砷酸(ATO)对NPM1阳性老年非早幼粒细胞急性髓细胞白血病( nonAPL AML)患者的疗效。方法 选取2012年2月~2017年2月我院收治的NPM1老年非早幼粒细胞AML患者76例为研究对象。将其按照随机数字表法均分成观察组和对照组,每组各38例。对照组予以小剂量阿糖胞苷(LDAC)化疗,观察组则在LDAC基础上联合ATO及ATRA化疗。分别比较两组早期死亡率、完全缓解率、复发率情况,不良反应发生情况以及1年生存率情况。结果 观察组完全缓解率高于对照组,而复发率低于对照组,差异有统计学意义(均P<005)。两组肝功能损害、胃肠道反应以及头痛发生率比较差异无统计学意义(均P>005)。观察组1年生存率高于对照组,差异有统计学意义(P<005)。结论 应用ATRA联合ATO及LDAC使老年NPM1阳性 nonAPL AML患者完全缓解率,降低复发率,延长1年生存率,具有较高的安全性,值得临床进一步研究。
关键词:  急性髓系细胞白血病  全反式维甲酸  老年  疗效  不良反应
DOI:
基金项目:
Effect of total trans retinoic acid combined with arsenite on NPM1 positive elderly patients with acute non promyelocytic leukemia
XIAO Rong,JIANG Tao,WAN Chunqian,LI Hui,LI Chenglong,CHE Feifei,CHEN Jiao,HUANG Xiaobing,WANG Chunsen,WANG Xiaodong
(Department of Hematology, Sichuan Academy of Medical Sciences, Sichuan Provincial People’s Hospital)
Abstract:
【Abstract】 Objective To study the effect of total trans retinoic acid (ATRA)combined with arsenite (ATO)on NPM1 positive elderly patients with acute nonpromyelocytic leukemiaAPL AML).Methods 76 elderly AML patients with NPM1 admitted to our hospital from February 2012 to February 2017 were selected as study subjects. According to the random number table method, they were divided into observation group and control group, 38 cases in each group. The control group was treated with lowdose cytarabine (LDAC)chemotherapy. The observation group was treated with ATRA and ATO and LDAC chemotherapy. The early mortality rate, complete remission rate, relapse rate were compared between the two groups. Adverse reactions and 1 year survival rates were compared.Results The complete remission rate of the observation group was, significantly higher than that of the control group. The recurrence rate of the observation group was significantly lower than the control group. The difference between the groups was statistically significant (all P< 005). The incidence of liver function injury, gastrointestinal reaction and headache in the observation group were not obvious, compared with the control group, and the difference between the groups was not statistically significant (all P>005). The 1year survival rate of the observation group (3684%) was higher than that of the control group (1579%). The difference between the groups was statistically significant (P< 005).Conclusion ATRA, in combination with ATO and LDAC is effective in the treatment of NPM1positive elderly patients with acute nonpromyelocytic leukemia, which can effectively provide complete remission rate, reduce the recurrence rate and extend the OS for 1 year, which is of high safety and worthy of further clinical study.
Key words:  Acute myeloid leukemia  Total trans retinoic acid  Old age  Curative effect  Adverse reactions

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