伊達比星對急性早幼粒細胞白血病的復發率及不良反應的影響

沈向理 張慧琪 黃靜 楊宇佳

[摘要] 目的 探討急性早幼粒細胞白血病（Acute promyelocytic leukemia，APL）患者使用伊達比星進行鞏固治療的效果，分析藥物對患者復發率及不良反應的影響。 方法 選取本院2011年11月～2013年11月收治的急性早幼粒細胞白血病患者60例，根據隨機數表法分為兩組，每組30例。所有患者均接受相同的誘導治療及維持治療，觀察組鞏固化療單用伊達比星，對照組鞏固化療則使用吡柔比星+阿糖胞苷。以3個月作為1個治療周期，對比兩組治療5個周期的療效、復發率、隨訪3年無病生存率及不良反應。 結果 觀察組中性粒細胞水平恢復時間及癥狀完全緩解時間短于對照組，差異均有統計學意義（P<0.05）；觀察組治療完全緩解率高于對照組，差異有統計學意義（P<0.05）。觀察組治療3年后無病生存率高于對照組，差異有統計學意義（P<0.05）；觀察組心臟毒性、消化系統毒性、感染及其他毒副反應發生率均低于對照組，差異有統計學意義（P<0.05）。 結論 急性早幼粒細胞白血病患者接受伊達比星進行鞏固化療利于加快患者各癥狀及體征快速緩解，近期復發率低，患者近期無病生存情況理想，且不良反應發生情況少，藥物使用安全有效。

[關鍵詞] 急性早幼粒細胞白血?。灰吝_比星；不良反應；復發率

[中圖分類號] R733.71 [文獻標識碼] B [文章編號] 1673-9701（2018）27-0074-04

[Abstract] Objective To investigate the effect of intensive treatment with idarubin in patients with acute promyelocytic leukemia（APL） and to analyze the effect of drugs on the relapse rate and adverse reactions. Methods 60 patients with acute promyelocytic leukemia who were admitted in our hospital from November 2011 to November 2013 were selected and divided into two groups according to the random number table method， with 30 cases in each group. All patients received the same induction therapy and consolidation chemotherapy. In the observation group， idarubicin was used for consolidation chemotherapy. In the control group， pirarubicin combined with cytarabine was used for consolidation chemotherapy. 3 months were taken as a treatment cycle. The curative effect and relapse rate after 5 cycles of treatment and disease-free survival rate and adverse reactions in 3-year follow-up were compared between the two groups. Results The recovery time of neutrophil level and complete symptom remission time in the observation group were shorter than those in the control group， and the difference was significant（P<0.05）. The complete remission rate in the observation group was higher than that in the control group. The difference was statistically significant（P<0.05）. The disease-free survival rate of the observation group after 3 years of treatment was higher than that of the control group， and the difference was significant（P<0.05）. The incidences of cardiac toxicity， digestive system toxicity， infection and other adverse reactions were lower in the observation group than those in the control group， and the difference was statistically significant（P<0.05）. Conclusion Patients with acute promyelocytic leukemia undergoing idarubicin for consolidation chemotherapyfacilitates rapid remission of symptoms and signs. The recent recurrence rate is low. The patient's recent disease-free survival is ideal， and the incidence of adverse reactions is small. The use of drugs is safe and effective.