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ASH 2012:急性早幼粒细胞白血病可用ATRA和ATO联合治疗代替化疗(APL0406研究)

2012-12-19 佚名 爱爱医

     第54届美国血液学年会(ASH)全体会议上展示了一个创新性的研究:急性早幼粒细胞白血病(APL)可以不用化疗,而用全反式维甲酸(ATRA)和三氧化二砷(ATO)联合治疗。   意大利罗马TorVergata大学的血液学教授FrancescoLo-Coco博士展示了他们的APL0406研究。他说这个研究结果提供了一个“打破教条”的证据。他们的结果显示有可能(用全反式维甲酸)将恶性癌细胞

  APL

  第54届美国血液学年会(ASH)全体会议上展示了一个创新性的研究:急性早幼粒细胞白血病(APL)可以不用化疗,而用全反式维甲酸(ATRA)和三氧化二砷(ATO)联合治疗。

  意大利罗马TorVergata大学的血液学教授FrancescoLo-Coco博士展示了他们的APL0406研究。他说这个研究结果提供了一个“打破教条”的证据。他们的结果显示有可能(用全反式维甲酸)将恶性癌细胞转化,而不是(用化疗)将其杀死。他在在记者发布会上说,“癌症并非不可逆”。

  APL0406研究是意大利40个研究中心和德国27个研究中心的Ⅲ期临床试验。这项临床试验包括162例初诊的,遗传学证实为非高危的APL患者。患者被随机地指定接收非细胞毒治疗(n=79),这些患者每日接受ATO0.15/kg和ATRA45mg/m2直到获得完全缓解。然后,ATO每周用5天,用4周,停4周,共4个疗程。ATRA用两周,停两周,共4个疗程。对照组患者(n=80)接受标准的ATRA加伊达比星诱导。3个疗程的蒽环类抗生素加ATRA巩固。然后,ATRA加低剂量的化疗(包括甲氨蝶呤和6-巯基嘌呤)维持。

  结果显示两组的结果非常类似。经过31月的中数随访,ATRA加ATO治疗组的两年无病生存率为97%;ATRA加化疗组的两年无病生存率为86.7%。两组的总生存率分别为98.7%和91.1%。ATRA加ATO治疗组有1例死亡;2例复发。ATRA加化疗组有3例死亡;5例复发。

  Lo-Coco博士总结,ATRA加化疗组的副作用较大,有发热、中性粒细胞减少延长、血小板减少明显而多见。ATRA加ATO治疗组则Q-T延长综合征发生率高(有1例为此停用ATO);肝脏毒性和白细胞增高(用羟基脲处理)多见,然而,这些副作用很容易处理,血液学毒性也较少。ATRA加ATO治疗组在对于低危和中危APL的2年无事件生存“至少不亚于“ATRA加化疗组。

   

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    2013-03-21 bsmagic9140
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    2013-01-07 Roberto

    Always refreshing to hear a rational awnser.

    0

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    2012-12-21 kksonne
  5. [GetPortalCommentsPageByObjectIdResponse(id=1947484, encodeId=543b194e4841c, content=<a href='/topic/show?id=c11f29e67e' target=_blank style='color:#2F92EE;'>#ATRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2976, encryptionId=c11f29e67e, topicName=ATRA)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/XhttJCp4Aq9gKA5n4v9elclQlVQTDenMiaEiadlI5D3gtmfSiaicoIY4ZsuibrQKLibDdxBKVY8oS6B2FicqJlT93clow/132, createdBy=03202500144, createdName=ms7258648636991762, createdTime=Sat May 04 21:00:00 CST 2013, time=2013-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1656562, encodeId=ef501656562da, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Thu Mar 21 23:00:00 CST 2013, time=2013-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=5338, encodeId=418e53381c, content=Always refreshing to hear a rational awnser., beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=Roberto, createdTime=Mon Jan 07 19:57:00 CST 2013, time=2013-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1301099, encodeId=3aea1301099f9, content=<a href='/topic/show?id=38e32852fe' target=_blank style='color:#2F92EE;'>#ASH#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2852, encryptionId=38e32852fe, topicName=ASH)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=39a0295, createdName=kksonne, createdTime=Fri Dec 21 07:00:00 CST 2012, time=2012-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1313611, encodeId=529a131361142, content=<a href='/topic/show?id=d4cc80e128f' target=_blank style='color:#2F92EE;'>#联合治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80712, encryptionId=d4cc80e128f, topicName=联合治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=263b421, createdName=zhaozuguo, createdTime=Fri Dec 21 07:00:00 CST 2012, time=2012-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423748, encodeId=df961423e483e, content=<a href='/topic/show?id=52cb52309d9' target=_blank style='color:#2F92EE;'>#急性早幼粒细胞白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52309, encryptionId=52cb52309d9, topicName=急性早幼粒细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ac03837582, createdName=ycmayy, createdTime=Fri Dec 21 07:00:00 CST 2012, time=2012-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1509500, encodeId=d33a15095004c, content=<a href='/topic/show?id=6a8e264431' target=_blank style='color:#2F92EE;'>#APL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2644, encryptionId=6a8e264431, topicName=APL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c81c10095307, createdName=风铃824, createdTime=Fri Dec 21 07:00:00 CST 2012, time=2012-12-21, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1947484, encodeId=543b194e4841c, content=<a href='/topic/show?id=c11f29e67e' target=_blank style='color:#2F92EE;'>#ATRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2976, encryptionId=c11f29e67e, topicName=ATRA)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/XhttJCp4Aq9gKA5n4v9elclQlVQTDenMiaEiadlI5D3gtmfSiaicoIY4ZsuibrQKLibDdxBKVY8oS6B2FicqJlT93clow/132, createdBy=03202500144, createdName=ms7258648636991762, createdTime=Sat May 04 21:00:00 CST 2013, time=2013-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1656562, encodeId=ef501656562da, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Thu Mar 21 23:00:00 CST 2013, time=2013-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=5338, encodeId=418e53381c, content=Always refreshing to hear a rational awnser., beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=Roberto, createdTime=Mon Jan 07 19:57:00 CST 2013, time=2013-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1301099, encodeId=3aea1301099f9, content=<a href='/topic/show?id=38e32852fe' target=_blank style='color:#2F92EE;'>#ASH#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2852, encryptionId=38e32852fe, topicName=ASH)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=39a0295, createdName=kksonne, createdTime=Fri Dec 21 07:00:00 CST 2012, time=2012-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1313611, encodeId=529a131361142, content=<a href='/topic/show?id=d4cc80e128f' target=_blank style='color:#2F92EE;'>#联合治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80712, encryptionId=d4cc80e128f, topicName=联合治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=263b421, createdName=zhaozuguo, createdTime=Fri Dec 21 07:00:00 CST 2012, time=2012-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423748, encodeId=df961423e483e, content=<a href='/topic/show?id=52cb52309d9' target=_blank style='color:#2F92EE;'>#急性早幼粒细胞白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52309, encryptionId=52cb52309d9, topicName=急性早幼粒细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ac03837582, createdName=ycmayy, createdTime=Fri Dec 21 07:00:00 CST 2012, time=2012-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1509500, encodeId=d33a15095004c, content=<a href='/topic/show?id=6a8e264431' target=_blank style='color:#2F92EE;'>#APL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2644, encryptionId=6a8e264431, topicName=APL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c81c10095307, createdName=风铃824, createdTime=Fri Dec 21 07:00:00 CST 2012, time=2012-12-21, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1947484, encodeId=543b194e4841c, content=<a href='/topic/show?id=c11f29e67e' target=_blank style='color:#2F92EE;'>#ATRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2976, encryptionId=c11f29e67e, topicName=ATRA)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/XhttJCp4Aq9gKA5n4v9elclQlVQTDenMiaEiadlI5D3gtmfSiaicoIY4ZsuibrQKLibDdxBKVY8oS6B2FicqJlT93clow/132, createdBy=03202500144, createdName=ms7258648636991762, createdTime=Sat May 04 21:00:00 CST 2013, time=2013-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1656562, encodeId=ef501656562da, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Thu Mar 21 23:00:00 CST 2013, time=2013-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=5338, encodeId=418e53381c, content=Always refreshing to hear a rational awnser., beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=Roberto, createdTime=Mon Jan 07 19:57:00 CST 2013, time=2013-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1301099, encodeId=3aea1301099f9, content=<a href='/topic/show?id=38e32852fe' target=_blank style='color:#2F92EE;'>#ASH#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2852, encryptionId=38e32852fe, topicName=ASH)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=39a0295, createdName=kksonne, createdTime=Fri Dec 21 07:00:00 CST 2012, time=2012-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1313611, encodeId=529a131361142, content=<a href='/topic/show?id=d4cc80e128f' target=_blank style='color:#2F92EE;'>#联合治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80712, encryptionId=d4cc80e128f, topicName=联合治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=263b421, createdName=zhaozuguo, createdTime=Fri Dec 21 07:00:00 CST 2012, time=2012-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423748, encodeId=df961423e483e, content=<a href='/topic/show?id=52cb52309d9' target=_blank style='color:#2F92EE;'>#急性早幼粒细胞白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52309, encryptionId=52cb52309d9, topicName=急性早幼粒细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ac03837582, createdName=ycmayy, createdTime=Fri Dec 21 07:00:00 CST 2012, time=2012-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1509500, encodeId=d33a15095004c, content=<a href='/topic/show?id=6a8e264431' target=_blank style='color:#2F92EE;'>#APL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2644, encryptionId=6a8e264431, topicName=APL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c81c10095307, createdName=风铃824, createdTime=Fri Dec 21 07:00:00 CST 2012, time=2012-12-21, status=1, ipAttribution=)]
    2012-12-21 风铃824

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