伊达比星对急性早幼粒细胞白血病的复发率及不良反应的影响

沈向理 张慧琪 黄静 杨宇佳

[摘要] 目的 探討急性早幼粒细胞白血病（Acute promyelocytic leukemia，APL）患者使用伊达比星进行巩固治疗的效果，分析药物对患者复发率及不良反应的影响。 方法 选取本院2011年11月～2013年11月收治的急性早幼粒细胞白血病患者60例，根据随机数表法分为两组，每组30例。所有患者均接受相同的诱导治疗及维持治疗，观察组巩固化疗单用伊达比星，对照组巩固化疗则使用吡柔比星+阿糖胞苷。以3个月作为1个治疗周期，对比两组治疗5个周期的疗效、复发率、随访3年无病生存率及不良反应。 结果 观察组中性粒细胞水平恢复时间及症状完全缓解时间短于对照组，差异均有统计学意义（P<0.05）；观察组治疗完全缓解率高于对照组，差异有统计学意义（P<0.05）。观察组治疗3年后无病生存率高于对照组，差异有统计学意义（P<0.05）；观察组心脏毒性、消化系统毒性、感染及其他毒副反应发生率均低于对照组，差异有统计学意义（P<0.05）。 结论 急性早幼粒细胞白血病患者接受伊达比星进行巩固化疗利于加快患者各症状及体征快速缓解，近期复发率低，患者近期无病生存情况理想，且不良反应发生情况少，药物使用安全有效。

[关键词] 急性早幼粒细胞白血病；伊达比星；不良反应；复发率

[中图分类号] R733.71 [文献标识码] B [文章编号] 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.