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目的 :研究急性早幼粒细胞白血病 (APL)合并出血的临床特征和全反式维甲酸(ATRA)对 APL 早期出血的影响。方法 :回顾性总结 110例 APL 患者的临床特点和实验室检查结果 ;并比较 ATRA治疗与传统化疗的疗效。结果 :110例患者合并出血 5 6例 (5 0 .9% ) ,早期出血死亡12例 (10 .9% )。早期出血死亡的危险因素有 :高白血病细胞 (>1× 10 9/ L) ,低血小板 (<30× 10 9/ L) ,低纤维蛋白原 (<1.5 g/ L) ,高龄 (>5 0岁 ) ,血红蛋白 (<10 g/ L)。ATRA治疗组早期出血死亡率 ,血小板 <30× 10 9/ L、纤维蛋白原 <1.0 g/ L 的时间 ,以及输注血制品次数均明显减少。结论 :APL 出血发生率较高 ;ATRA治疗明显减少早期出血死亡率 ,提高了 APL 的缓解治愈率
Objective: To investigate the clinical characteristics of acute promyelocytic leukemia (APL) combined with hemorrhage and the effect of all-trans retinoic acid (ATRA) on early-stage APL bleeding. Methods: The clinical features and laboratory findings of 110 APL patients were retrospectively reviewed. The efficacy of ATRA and conventional chemotherapy was compared. Results: Fifty-six patients (50.9%) had hemorrhage in 110 patients and 12 patients (10.9%) died of early hemorrhage. The risk factors for early hemorrhage were high leukemia (> 1 × 10 9 / L), low platelet (<30 × 10 9 / L), low fibrinogen (1.5 g / L) Years old), hemoglobin (<10 g / L). ATRA treatment group early mortality, platelet <30 × 10 9 / L, fibrinogen <1.0 g / L of the time, and the number of transfusions of blood products were significantly reduced. Conclusions: The incidence of APL hemorrhage is high. ATRA treatment significantly reduces the mortality of early hemorrhage and improves the cure rate of APL.