论文部分内容阅读
采用全反式维甲酸 (ATRA)治疗急性早幼粒细胞白血病 (APL) 6 3例 ,其高白细胞综合征、高颅压综合征及维甲酸综合征的发生率分别为 5 7.1% ,9.5 %和 3.2 % ;其死亡率为 11.1% ;高白细胞综合征导致白细胞壅滞是死亡的原因。笔者建议 :ATRA治疗APL时 ,当白细胞在第 6天 >5 .0× 10 9·L- 1 ,第 10天 >10 .0× 10 9·L- 1 ,第 15天 >15 .0× 10 9·L- 1 时应加用高三尖杉酯碱治疗 ;当患者的白细胞在ATRA治疗前≥ 10 .0× 10 9·L- 1 ,则先单用高三尖杉酯碱 ,待白细胞下降至≤ 5 .0× 10 9·L- 1 ,再加用维甲酸治疗 ;一旦发生维甲酸综合征则应停用维甲酸 ,同时给予皮质激素治疗
The use of all-trans retinoic acid (ATRA) in the treatment of 63 acute promyelocytic leukemia (APL) patients, the incidence of high leukocyte syndrome, high intracranial pressure syndrome and retinoid syndrome were 5 7.1%, 9.5%, respectively. And 3.2%; its mortality rate was 11.1%; high leukocyte syndrome causes white blood cell stasis is the cause of death. The authors suggest that when ATRA is used to treat APL, when the white blood cells are >5. 0×10 9 ·L − 1 on the 6th day, the 10th day>10. 0×10 9 ·L − 1, the 15th day> 15. 0× 10 9 · L - 1 should be treated with homoharringtonine; when the patient’s white blood cells are ≥ 10 .0 × 10 9 · L - 1 before ATRA treatment, homoharringtonine is used alone until leukocytes are reduced to ≤ 5 .0×10 9·L - 1 plus treatment with retinoic acid; once retinoic acid syndrome occurs, retinoic acid should be stopped and corticosteroids should be given at the same time