全反式维甲酸治疗急性早幼粒细胞白血病的严重副反应.pdfVIP

2000, 25( 3) BULL HUNAN MED UNIV 283 韩照平, 卢汉波, 沈泽霜 第二附属医院血液科( 长沙 410011) [ ] 采用全反式维甲酸 ( ATRA) 治疗急性早幼粒细胞白血病 ( APL) 63 例, 其 白细胞综合征 颅压综合 征及维甲酸综合征的发生率分别为57. 1% , 9. 5% 和 3. 2% ; 其死亡率为 11. 1% ; 白细胞综合征导致白细胞壅滞是 9 - 1 9 - 1 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 !L , 第10 天 10. 0 10 !L , 第15 天 9 - 1 9 - 1 15. 0 10 !L 时应加用 三尖杉酯碱治疗; 当患者的白细胞在 ATRA 治疗前∀10. 0 10 !L , 则先单用 三尖杉酯 9 - 1 碱, 待白细胞下降至# 5. 0 10 !L , 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 [ ] 维甲酸; 白血病; 急性病; 副反应; 治疗应用 [ ] R55 [ ] A [ ] 2000) Severe side effects of the treatment of acute promyelocytic leukemia with alltrans retinoic acid HAN Zha ping, LU Hanba , SHEN Zeishuang Dep artment of H ematology , The Second Aff iliated H osp ital , Hunan Medical Univers ity ( Changsha 410011) [ Abstract] Sixtythree cases with acute pr myel cytic leukemia ( APL) were treated with alltrans retin ic acid ( ATRA) . The rates f hyperleuk cyt sis, intracranial hypertensi n, retin ic acid syndr me were 57. 1% , 9. 5%, and 3. 2% respectively. M rtality f the treatment was 11. 1%. Under ATRA treatment, hyperleuk cyt sis leading t leuk stasis was the cause f death in patients with APL. We theref re suggest that the patients with 9 - 1 9 - 1 9 - 1 such leuk cyte levels ( that is, 5. 0 10 !L n the 6th day, 10. 0 10 !L n the 10th day, 15. 0