The analysis of 183 patients with acute promyelocytic leukemia accompanied by disseminated intravascular coagulation / 白血病·淋巴瘤

ABSTRACT

Objective To analyse the outcome of different regimens for the treatment to patients with aeute promyelocytic leukemia(APL)accompanied by disseminated intravagcular coagulation(DIC).Methods The outcome of different chemotherapy regimens was compared. Results The median time achieving complete remission by all-trans retinoic acid(ATRA)combined with arsenic trioxide(As2O3)or alternative of ATRA and As2O3 were 34 days and 35.5 days,respectively.The median time of CR for the patients treated with ATRA only was 62 days.There is a statistical difference where three-year disease-free survival rates of the patients given by ATRA and As2O3 or alternative of them were 78 percent and 80 percent,respectively.Compared with the patients administered with ATRA only.there is significant difference(P＜0.05).The time of improving DIC was about 16 days to 18 days.There was no significant difference among this three chemotherapy regimens.Among 15 patients with autologous henmtopeietic stem cell transplantation,the disease-free survival time of 13 cases.who have no PML-RARα gene deteced by PCR was 13.5 years except 2 cases with relapse.Conclusion The time achieving complete remission of APL was reduced dramaticaly by administering all-trans retinoic acid(ATRA)combined with arsenic trioxide(As2O3)or alternative treatment of them and principles of blood transfusion and anti-fibmolysis to improve DIC,this regimen showed a relatively higher three-year disease-free survival (DFS) rate.These cases who received hematopeietic stem cell transplantation after six mortths of remission,DFS time wag further prolonged.