| Objective：To analysis combined effect of arsenic trioxide and chemotherapy foracute promyelocytic leukemia patients..Methods：63patients with newly diagnosed adult acute promyelocyticleukemia(APL), all received regular treatment in the Hematology Department ofXiamen Zhongshan Hospital，Union Clinical Medical College of Fujian MedicalUniversity，were retrospectively analysed as Experimental Group from January1st2001to December31th2010. They were divided into high WBC group and low WBCgroup according to the numeration of leukocyte of the first visit, and receivedall-trans-retinoic (ATRA) and arsenic trioxide(ATO) until complete remission. ATOand chemotherapy were used in turn as consolidation therapy after completehematologic remission. Five cycles were finished in the first year. Patients received atleast one course of HD-Ara-c and more one intrathecal injection of three drugscontaining methotrexate, cytarabine and dexamethasone. Patients regular monitoredPML/RARa fusion gene every6month for2years after consolidation therapy werecompleted without no maintenance therapy. Control Group A received onlychemotherapy as consolidation therapy, while Control Group B received only ATO.The two control groups were chosen from other similar clinic trials. Collect survivalmaterial, compare with complete remission rate, the rate of PML/RARa fusion geneturning into negative,1-year,2-year and5-year overall survival rate (OS),5-yearrecurrence-free surial rate(RFS) among different groups. Patient actuarial survivalwas determined by Kaplan-Meier analysis. Chi-square test was used to compare therates.Results:2patients died and1patient recrudesced.1patient received stem celltransplantation. CR rate was100%. There was no patients dead in the first month oftherapy. The rate of PML/RARa fusion gene turning into negative was96.8%.1-yearOS was98.41%.2-year OS was98.41%（±1.576）.5-year OS was95.84%（±7.82） while5-year RFS was97.92%（±5.65）. The5-year OS of Experimental Group wassignificantly higher than the5-year OS of Control Group A. The rate of recurrence ofExperimental Group was significantly lower than Control Group B.2-year OS of thehigh WBC group was100%while5-year OS was91.6%（±23.18）,5-year RFS was91.67%（±23.18）.2-year OS of low WBC group was97.88%（±2.101） while5-year OS was90.00%（±25）,5-year RFS100%. There is no statistical significancethese three datas between the two groups.Conclusion:：1）For newly diagnosed acute promyelocytic leukemia after completeremission, the regimen of ATO combined with chemotherapy in turn for consolidationtherapy were effective and safe, whileas5-year OS was95.84%.2）Both highrisk andlowerisk groups got similar outcome if patients received this regimen.5-year OS ofthe two groups were both over90%and there was no statistical significance.3) CNSLof APL could be availably avoided with this regimen for consolidation therapy.4)After completing this therapy regimen, the patients whose PML/RARa fusion genefailed to turning negative persistently should receive stem cell transplantation. |
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