Leukocytosis and the retinoic acid syndrome in patients with acute promyelocytic leukemia treated with arsenic trioxide
Leukocytosis and the retinoic acid syndrome in patients with acute promyelocytic leukemia treated with arsenic trioxide
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DOI：
10.1200/jco.2000.18.13.2620
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发表时间：
2000-07-01
影响因子：
45.3
通讯作者：
Warrell, RP
中科院分区：
文献类型：
--
作者：
Camacho, LH;Soignet, SL;Warrell, RP
目的：三氧化二砷与全反式维甲酸（RA）一样，在体内诱导急性早幼粒细胞白血病（APL）细胞分化。用全反式PA治疗APL患者通常与白细胞增多有关，大约50%的患者发展为PA综合征。我们回顾了我们的临床经验与三氧化二砷，以确定这两个phenomenon.Patients和Methods的发病率：26例复发性或难治性APL患者进行了治疗与三氧化二砷缓解诱导，每日剂量范围从0.06至0.17 mg/kg.Results：23例（88%）达到完全缓解。在15例患者（58%）中观察到白细胞增多。白细胞增多患者的基线白细胞计数中位数为3，900个细胞/μ L（范围：1，200 - 72，300个细胞/μ L），高于未发生白细胞增多的患者（2，100个细胞/μ L;范围：500 - 5，400个细胞/μ L; P = 0.01）。未给予其他细胞毒性治疗，所有病例的白细胞增多均消退。在8例患者（31%）中观察到PA综合征。发生白细胞增多的患者更容易发生PA综合征（P
Purpose: Arsenic trioxide, like all-trans-retinoic acid (RA), induces differentiation of acute promyelocytic leukemia (APL) cells in vivo. Treatment of APL patients with all-trans PA is commonly associated with leukocytosis, and approximately 50% of patients develop the PA syndrome. We reviewed our clinical experience with arsenic trioxide to determine the incidence of these two phenomena.Patients and Methods: Twenty-six patients with relapsed or refractory APL were treated with arsenic trioxide for remission induction at daily doses that ranged from 0.06 to 0.17 mg/kg.Results: Twenty-three patients (88%) achieved complete remission. Leukocytosis was observed in 15 patients (58%). The median baseline leukocyte count for patients with leukocytosis was 3,900 cells/mu L (range, 1,200 to 72,300 cells/mu L), which was higher than that for patients who did not develop leukocytosis (2,100 cells/mu L; range, 500 to 5,400 cells/mu L; P =.01). No other cytotoxic therapy was administered, and the leukocytosis resolved in all cases. The PA syndrome was observed in eight patients (31%). Patients who developed leukocytosis were significantly more likely to develop the PA syndrome (P