| Backgroundthe treatment of acute promyelocytic leukemia have made siginificant breakthrough in the field of treatment in the acute leukemia.Due to the application of new targeted drugs and optimal selection of treatment make it a curable disease, As there was still 1/10 patients relapse,to keep APL patient sustaining complete remission(CCR) is a hot spot of current research.ObjectiveRetrospective analysis effectiveness and adverse reaction of ATRA?ATO combined with different schemes of chemotherapy in treating acute promyelocytic leukemia,including induction therapy ? consolidation treatment and maintenance treatment.MethodsSixty-nine patients with APL was collected in this study,who hospitalized in Department of Hematology of the First Affiliated Hospital,Zhengzhou University from july 2003 to july 2010. all patients were treated with ATRA and As2O3 for induction remission,then three period of consolidation treatment.maintenance treatment:to administer ATRA ? As2O3 and different schemes of chemotherapy alternately to the patients.complete remission(CR) rate,Early mortality,molecular remission rate,five-year overall survival(OS) rate,five-year disease-free survival(DFS) rate and adverse reaction.ResultsWhite blood cell count > 10×109/L group compare with white blood cellcount?10×109/L group, complete remission(CR) rate,five-year overall survival(OS)rate and five-year disease-free survival(DFS) rate are lower,there was a significant different in five-year overall survival(OS) rate and five-year disease-free survival(DFS) rate between the two groups(P value were 0.017, 0.04).platelet count?40×109/L group compare with platelet count < 40×109/L group,five-year disease-free survival(DFS) rate is higher,there was a significant different in five-year disease-free survival(DFS) rate between the two groups(P=0.006).the overall CR rate of 69 patients was 94.2%.after three courses of consolidation treatment,molecular remission rate was 100%.early mortality was 5.8%.five-year overall survival(OS) rate and five-year disease-free survival(DFS) is 92.8%,91.3%respectively.there were only two cases recurred for the molecular biology.Conclusions1. High WBC and low PLT are adverse factors for the patients with APL.2. ATRA combinded with As2O3 as the remission induction therapy,followed with 3 course of treatment as consoldation therapy,sequential therapy combinding As2O3?ATRA and other chemotherapy alternately as the maintenance chemotherapy had been found as a safe and practical method to obtain a long-term disease-free survival for the patients with APL.3.Detecting the PML-RAR? fusion gene made a big importance for the early molecular biology recurrence. |
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