本文選題：急性早幼粒細胞白血病　切入點：細胞毒藥物　出處：《河北醫(yī)科大學》2017年碩士論文

【摘要】：目的:探索急性早幼粒細胞白血病(APL)分子學緩解后限制細胞毒藥物的維持治療。方法:將符合細胞形態(tài)學、免疫學、細胞遺傳學、分子生物學(MICM)分型標準的80例初治APL患者,采用全反式維甲酸(ATRA)單藥或ATRA聯(lián)合蒽環(huán)類藥物進行誘導分化治療,達完全緩解(CR)后采用蒽環(huán)類藥物或聯(lián)合阿糖胞苷(Arac)的方案鞏固治療2~3次,達分子學緩解后非完全隨機分為2組,A組接受三氧化二砷(AS2O3)和ATRA交替序貫維持治療,B組接受AS2O3和ATRA和化療交替序貫維持治療。比較2組患者維持治療期間的并發(fā)癥情況及治療花費、無進展生存(PFS)率及總體生存(OS)率。結果:1 A組與B組的感染并發(fā)癥發(fā)生率分別為20%(8/40)和67.5%(27/40)(χ2=18.337,P=0.000),A組的感染并發(fā)癥明顯低于B組(P0.05),差異有統(tǒng)計學意義;2患者每次住院花費平均數(shù)分別為11132.00元和12510.45元(t=5.145,P=0.031);A組的治療花費明顯低于B組(P0.05),差異有統(tǒng)計學意義;3 A組和B組5年預計PFS率分別為(75.2±13)%和(67.6±12.2)%(χ2=0.352,P=0.5530.05),兩組PFS差異無統(tǒng)計學意義(P0.05);4 5年預計OS率分別為(95.2±4.6)%和(70.0±18.2)%(χ2=0.2000,P=0.6550.05),兩組OS差異無統(tǒng)計學意義(P0.05)。結論:APL患者在獲得完全分子學緩解后采用限制細胞毒藥物維持治療可以減少并發(fā)癥發(fā)生及治療花費。
[Abstract]:Objective: to explore the maintenance treatment of cytotoxic drugs after molecular remission of acute promyelocytic leukemia (AHL). Methods: 80 newly diagnosed APL patients who met the criteria of cell morphology, immunology, cytogenetics and molecular biology were used. All trans retinoic acid (ATRA) single drug or ATRA combined with anthracycline were used to induce differentiation, and complete remission was achieved, then the regimen of anthracycline or cytarabine was used to consolidate treatment for 23 times. After molecular remission, patients in group A were randomly divided into two groups: group A received AS2O3) and group B received alternative sequential maintenance therapy of AS2O3, ATRA and chemotherapy. Symptoms and treatment costs, Results the incidence of infection complications in group A and group B were 20 / 8 / 40) and 67.5 / 27 / 40 respectively (蠂 ~ (2) ~ (18) 337p ~ (0.000)) were significantly lower than those in group B (P = 0.05). The difference was statistically significant (P < 0.05). The incidence of infection complications in group A was significantly lower than that in group B (P = 0.05), and the incidence of infection complications in group A was significantly lower than that in group A (P < 0.05), and the incidence of complications in group B was significantly lower than that in group A (P < 0.05). The mean value of PFS in group A was 11132.00 yuan and 12510.45 yuan respectively. The cost of treatment in group A was significantly lower than that in group B (P 0.05). The difference was statistically significant between group A and group B, the estimated 5-year PFS rates in group A and group B were 75.2 鹵13.1% and 67.6 鹵12.2g respectively (蠂 20.352P 0.5530.05). There was no significant difference in PFS between the two groups. In order to achieve 95.2 鹵4.6% and 70.0 鹵18.2%, there was no significant difference in OS between the two groups (蠂 2 / 0.2000). Conclusion the treatment of limiting cytotoxic drug maintenance in patients with 1% APL can reduce the incidence of complications and the cost of treatment after obtaining complete molecular remission.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R733.71

【參考文獻】

相關期刊論文 前10條

1 姚曉非;;73例急性早幼粒細胞性白血病患者臨床特點和預后分析[J];中國實用醫(yī)藥;2016年36期

2 王林婭;鄭胡鏞;;兒童急性早幼粒細胞白血病低危組的治療進展[J];中國小兒血液與腫瘤雜志;2016年06期

3 廖麗娟;;研究熒光原位雜交技術用于急性早幼粒細胞白血病患者診治中的臨床效果[J];中國實用醫(yī)藥;2016年25期

4 張靜宜;孫桂波;王敏;孫曉波;;三氧化二砷心臟毒性研究進展[J];中國藥理學通報;2016年09期

5 廖永梅;王淋;王秀梅;何雪花;梁元碧;;三氧化二砷維持治療急性早幼粒細胞白血病對患者血脂代謝及遠期生存率的影響[J];安徽醫(yī)藥;2016年07期

6 李彥畢;張藝;;砷劑聯(lián)合全反式維甲酸治療M3型小兒急性早幼粒細胞白血病[J];現(xiàn)代腫瘤醫(yī)學;2016年14期

7 鞠滿凱;張磊;;急性早幼粒細胞白血病發(fā)病機制研究新進展[J];醫(yī)學綜述;2016年08期

8 李森;王書杰;;急性早幼粒細胞白血病治療方案的優(yōu)化研究[J];中國實用內(nèi)科雜志;2016年04期

9 王Z，

本文編號：1697903