Effect of arsenic trioxide maintenance therapy on long - term recurrence rate in patients with acute promyelocytic leukemia / 中国基层医药

ABSTRACT

Objective To explore the effect of arsenic trioxide maintenance therapy on the long-term recur-rence rate in patients with acute promyelocytic leukemia ( APL ) . Methods From December 2011 to December 2013,60 patients with APL in the First People's Hospital of Huzhou were selected and divided into control group and observation group according to random number table, with 30 cases in each group. All patients received the same induction therapy and consolidation therapy. During the maintenance treatment period, all - trans retinoic acid ( ATRA) was given to the control group,and arsenic trioxide was used in the observation group. The serum levels and incidence of adverse reactions in the two groups were detected and compared after two cycles of the maintenance therapy. Three years of follow - up was conducted after treatment to record and compare the recurrence rate and survival rate in the two groups. Results The levels of TC and TG after 1 and 2 cycles of treatment were higher than those before treatment in both two groups(all P<0. 05),but the levels of lipid indicators in the observation group were lower than those in the control group,and the differences were statistically significant (t=2. 044,2. 175,all P<0. 05). The incidence rates of retinoic acid syndrome,elevated intracranial pressure and other adverse reactions in the observation group during the treatment were lower than those in the control group(6. 67％ vs. 26. 67％,6. 67％ vs. 30. 00％,6. 67％ vs. 26. 67％),and the differences were statistically significant(χ2 =0. 043,0. 023,0. 043,all P<0. 05). The survival rates after 2 and 3 years of treatment in the observation group were higher than those in the control group(90. 00％ vs. 66. 67％,83. 33％ vs. 60. 00％),and the differences were statistically significant(χ2 =4. 812,4. 812,all P<0. 05). The recurrence rate after 3 years of treatment in the observation group was lower than that in the control group(10. 00％ vs. 33. 33％),and the difference was statistically significant(χ2 =4. 812,P <0. 05). Conclusion For patients with APL, the application of arsenic trioxide in the maintenance therapy can produce no significant effect on their lipid metabolism, and at a certain extent, can help reduce the incidence of adverse reactions and recurrence rate,and improve the survival rate.