【摘要】 目的:观察全反式维甲酸(ATRA)与化疗交替治疗急性早幼粒细胞白血病(APL)的长期疗效。方法:对17例经ATRA治疗取得完全缓解(CR)的APL患者,采用ATRA与化疗交替方案进行治疗。在治疗6个月以后,采用血细胞短期培养G显带技术进行染色体核型分析,RT蛳PCR技术检测PML蛳RARα融合基因,流式细胞术(FCM)检测CD+13 CDdim45 细胞和CD+33 CDdim45 细胞,监测t(15;17)染色体异位、PML蛳RARα融合基因以及CD+13 CDdim45 细胞和CD+33 CDdim45 细胞变化情况。结果:随访15 个月~ 70个月(中位数36个月),白血病复发3例,复发率17.65 %,总生存率(OS)94.12 %,t(15;17)染色体异位、PML蛳RARα融合基因和FCM检测MRD转阴率分别为23.53 %、29.41 %和23.53 %。结论:APL CR后采用ATRA与化疗交替治疗,可以较好地减少或消除APL患者体内的残存白血病细胞,减少白血病的复发率,延长患者的生存期,提高APL的临床治愈率。更多还原

【Abstract】 Objective:In order to observe the clinical long - time outcome of treatment of acute promyelocytic leukemia(APL)with all - trans retinoic acid(ATRA)plus chemotherapy.Methods:All the17patients with APL were treated by ATRA plus chemotherapy after complete remission(CR).The chromosome karyotypes were analyzed by G banding technique,PML - RARαfusion genes were detected by RT - PCR,CD +13 CD dim45 cells and CD +33 CD dim45 cells were detected by flow cytometry(FCM)to all the patients after six-month treatment.Results:In the treatment with ATRA plus chemotherapy for15to70months(mean36months),the leukemia relapsing rate was17.65%,the overall survival(OS)was94.12% and the rate of t(15;17)translocation,PML - RARαfusion gene and the minimal residual disease(MRD)detected by FCM becoming negative was23.53%,29.41%and23.53%,respectively.Conclusions:The treatment of ATRA plus chemotherapy for APL may reduce the leukemic clone,decrease the leukemia relapse rate and the patients’survival time and clinical curel rate may be improved.更多还原