关键词: 急性早幼粒细胞白血病；砷剂；维甲酸；联合治疗；预后因素

Abstract:

Abstract:Objective
To observe the therapeutic effect of   arsenic trioxide(ATO) in combination with   all-trans retinoic acid(ATRA) in treatment of newly diagnosed acute promyelocytic leukemia (APL),and analyze the influencing factors of induction treatment.Methods 107 newly diagnosed APL patients treated by both ATO and ATRA  were divided into high risk,medium risk,low risk,coarse granular(M3a),fine granular(M3b),L-type isoform ,S-type isoform typical karytype,additional karyotype groups according to different risk ranks,morphological  subtypes，fusion gene types and different chromosome types.The early mortality,complete remission(CR) rate,and CR  achieving time  of each group were detected,the prognostic factors influencing the therapeutical effect were determined.Results ①10 of all 107 patients died in early stage,the early mortality was 9.35%,the most common adverse reactions were disorder of coagulation and leukocytosis.②High risk group had obvious differences with medium and low risk groups in early mortality,CR rate and CR achieving time(P>0.05),but there was no difference between the latter two groups(P>0.05). M3b group had longer CR achieving time than M3a group,but they had the same CR rate (P>0.05).The CR rate in (L＋) group was higher than that in (S＋) group. Typical karyotype group had the same CR rate (P>0.05) and CR achieving time as the additional karyotype group (P>0.05).
Conclusion Initial WBC count,morphological subtypes,fusion gene types are important influencing factors for CR in patients with newly diagnosed APL treated by    ATRA in combination with  ATO.However,additional karyotype has little impact on short ter
m CR.

Key words: acute promyelocytic leukemia；arsenic trioxide；all-trans retinoic acid；combination treatment；prognostic factors