The Exploration Of Maintenance Therapy With The Limitation Of Cytotoxic Drugs After The Acute Promyelocytic Leukemia Molecular Remission

Objective: To explore the maintenance therapy with the limitation of cytotoxic drugs after the acute promyelocytic leukemia(APL)molecular remission.Methods:Apply the induced differentiation therapy to 80 initially-treated APL patients who meet a criterion of cell morphology,immunology,cytogenetics,and molecular biology(MICM)classification standards by using all trans retinoic acid(ATRA)monotherapy or ATRA combined with anthracycline.After complete remission(CR),the consolidation therapy of anthracycline or combined with cytarabine(Arac)were given for 2-3 times.After molecular remission,the patients were divided into two groups non-complete randomly,group A received arsenic trioxide(AS2O3)and ATRA alternately sequential maintenance therapy,group B received AS2O3,ATRA and chemotherapy alternately sequential maintenance therapy.Compare the complications,treatment cost,progression free survival rate(PFS)and overall survival rate(OS)during the period of maintenance therapy between two groups.Results:1 The incidence rate of infectious complications in group A and group B were 20%(8/40)and 67.5%(27/40)(?2=18.337,P=0.000<0.01)respectively,the incidence rate of infection complication in group A was significant lower than that in group B(P < 0.05),the difference was statistically significant;2 The average costs of patients per hospitalization were 11132.00 Yuan and 12510.45 Yuan(t= 5.145,P=0.031<0.05),respectively;The treatment cost of A group was significantly lower than that of group B(P < 0.05),the difference was statistically significant;3 The estimated 5-year progression-free survival rate(PFS)were(75.2±13)% and(67.6±12.2)%(?2=0.352,P=0.553>0.05),respectively;there was no statistical significance between the differences of two groups in terms of PFS(P >0.05);4 The 5 years estimated overall survival(OS)rate were(95.2±4.6)% and(70.0±18.2)%(?2=0.2000,P=0.655>0.05),respectively,there was no statistical significance between the differences of two groups in terms of OS(P >0.05).Conclusions: After the complete molecular remission,the incidence of complications and treatment cost can be reduced for APL patients by using the maintenance therapy with the limitation of cytotoxic.