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目的：总结全反式维甲酸（ATRA）治疗急性早幼粒细胞白血病（APL）经验，探讨如何降低治疗中的早期死亡率。方法：选择60例确诊为APL的患者，采用ATRA治疗。结果：53例（883％）达完全缓解。29例（483％）出现白细胞增多症，9例出现高白细胞综合征，加用小剂量三尖杉酯碱、羟基脲或米托蒽醌，8例症状消失。6例出现维甲酸综合征，使用甲基强的松龙或地塞米松并用小剂量ATRA治疗后4例好转。结论：早期识别ATR毒副作用，尽早治疗，可以降低APL患者早期死亡率。
Objective: To summarize the experience of all-trans retinoic acid (ATRA) in the treatment of acute promyelocytic leukemia (APL) and to explore how to reduce early mortality during treatment. METHODS: Sixty patients with confirmed APL were selected and treated with ATRA. Results: 53 cases (883%) achieved complete remission. 29 cases (483%) had leukocytosis, 9 cases had high leukocyte syndrome, plus a small dose of harringtonine, hydroxyurea, or mitoxantrone, and symptoms disappeared in 8 cases. Six patients developed retinoic acid syndrome, and 4 patients improved after using methylprednisolone or dexamethasone and treating with small doses of ATRA. Conclusion: Early identification of ATR toxicities and early treatment can reduce early mortality in patients with APL.