目的:比较2种不同诱导缓解方案治疗初发急性早幼粒细胞白血病(APL)的疗效.方法:48例APL患者随机分为全反式维A酸(ATRA)联合小剂量高三尖杉酯碱治疗组(A组)和ATRA联合亚砷酸(ATO)治疗组(B组).结果:A组完全缓解(CR)率为88.0%,达到CR时间为(28.9±1.9)d,B组CR率为91.3%,达到CR时间为(27.8±2.1)d,2组疗效、早期病死率及APL分化综合征发生率差异均无统计学意义(P>0.05).结论:ATRA联合小剂量高三尖杉酯碱诱导缓解治疗初发APL可以取得与ATRA联合ATO方案类似的效果,而治疗成本较低,在经济欠发达地区有推广应用价值.%Objective: To compare the outcome of two different remission induction therapies for patients with acute promyelocytic leukemia(APL). Methods: Forty-eight patients with APL were randomly divided into group A and group B. Group A were treated with all-trans retinoic acid ( ATRA ) and low dose of homoharringtonine ( LD-HHA) , and group B ATRA combined with arsenic trioxide ( ATO) . ResultS;The complete remission( CR) rate was 88. 0% in group A and 91. 3% in group B. The average time to achieve CR in the two groups was(28. 9 ?.9)d and(27. 8 ?. 1) d, respectively. There were no significant differences in the curative effect, early death rate or the incidence of differentiation syndrome between the two groups. Conclusions: The therapy of ATRA combined with LD-HHA may achieve similar curative effect as that of ATRA combined with ATO, but has the advantage of lower medical cost. So it is worth popularizing especially in less developed areas.
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