- 期刊
急性前骨髓球性白血病－30例之臨床觀察
Clinical Observations of 30 Patients with Acute Promyelocytic Leukemia
摘要
自1977年9月至1985年10月，觀察30位急性前骨髓球性白血病病帣，臨床上診斷時初發症狀，主要為出血現象，尤其以瘀斑出血最多，佔80%。24位病人作治療前凝血機能檢查，17位出現播散性血管內凝固症候群。11位病人沒有接受治療，其中6位經診斷後平均2.5天內死於腦內出血，凝血機能檢驗顯示5位有播散性血管內凝固症候群。19位病人接受anthracycline與ara-C併用預防性肝素靜脈滴注作緩解誘導治療，2位不完全治療，其餘17位中有8位經過平均63天之化學治療得到完全緩解，緩解率47%。有4位經過平均中數13個月之緩解期間再發死亡，其餘4位分別經過7、8、15與24個月之維持治療與追踪，目前仍在緩解中。 比較完全緩解組與治療失敗組，我們發現只有年齡因素 (以30歲前後為界線)可預測其治療結果 (p＜0.02)。
關鍵字
無資料並列摘要
Thirty patients with acute promyelocytic leukemia were observed between September 1977 and October 1985. Bleeding diathesis with petechiae or ecchymosis (80%) was the most common presenting symptom. Seventeen of 24 patients with pretreated coagulation studies were diagnosed to have disseminated intravascular coagulation (DIC). Six out of 11 patients died from intracranial hemorrhage after a mean of 2.5 days of hospitalization without any treatment. DIC was responsible for death in most cases. Induction therapy with anthracycline (daunomycin or doxorubicin) and cytosine arabinoside combined with prophylactic heparin infusion was carried out in the remaining 19 patients. Two patients were incompletely treated. Eight out of 17 patients achieved complete remission after a mean of 63 days following chemotherapy. The remission rate was 47%. Four patients died of relapses with a median remission duration of 13 months. The other four cases are currently in remission state under maintenance therapy after 7, 8, 15, and 24 months, respectively, of follow-up. Age alone was found to be significantly related to the outcome of chemotherapy when comparing several factors between remission and failure groups.