Compound realgar and natural indigo tablet therapy in acute promydocytic leukemia: a systematic review and meta-analysis

( views:258, downloads:0 )
Author:
HE Gan-lin(Center of Oncology & Hematology, The First Affiliated Hospital, Guangzhou Medical College, Guangzhou 510230, China)
WANG Chun-yar(Center of Oncology & Hematology, The First Affiliated Hospital, Guangzhou Medical College, Guangzhou 510230, China)
TAN Huo(Center of Oncology & Hematology, The First Affiliated Hospital, Guangzhou Medical College, Guangzhou 510230, China)
Journal Title:
Journal of Leukemia & Lymphoma
Issue:
Volume 20, Issue 09, 2011
DOI:
10.3760/cma.j.issn.1009-9921.2011.09.009
Key Word:
Leukemia, promyelocytic, acute;Meta analysis;Randomized controlled trial;Compound realgar and natural indigo tablet;Systematic review

Abstract: Objective To systematically review the curative effect and safety of compound realgar and natural indigo tablet (CRNIT) therapy in acute promyelocytic leukemia (APL). Methods The clinical data of randomized trials on SinoMed, CNKI, VIP, WANFANG DATA, CBA, PubMed, MEDLINE, EMBASE, the Cochrane Library were searched by internet, in addition to manual retrieval and collecting all published literatures randomized controlled trials (RCT) about CRNIT therapy in APL home and abroad. Retrieval line was up to March 2011. According to the inclusion criteria and exclusion criteria, screening all literatures and evaluating their qualities. The rate of complete remission (CR), time to CR, recurrence rate, mortality, rate of adverse reaction and so on were used as evaluation indicators for meta-analysis by RevMan 5.1. Results Data from six RCTs involving 391 APL patients, including 2 RCTs about comparison of CRNIT and Arsenic Trioxide (ATO), 4 RCTs about comparison of CRNIT and all-trans retinoic acid (ATRA) (including adding 1 RCT about comparison of CRNIT + ATRA and ATRA). Time to CR: CRNIT was longer than ATRA and ATO (WMD = 3.14, 95 % CI 0.99-5.29, P= 0.004). Headache incidence: CRNIT was lower than ATRA (OR = 0.10, 95 % CI 0.02-0.45, P = 0.003). 5-year disease-free survival rate: CRNIT was better than ATRA (OR = 7.22, 95 % CI 1.40-37.25, P = 0.02). There were no statistical significance in the rest of the Meta-analysis results.Conclusion The time to CR of CRNIT is longer than that of ATRA and ATO. The short-term effect of CRNIT is similar to that of ATRA and ATO. The 5-year disease-free survival rate of CRNIRT may be higher than that of ATRA.

  • [1]HU Xiao mei,LIU Feng,MA Rou.Application and assessment of chinese arsenic drugs in treating malignant hematopathy in China.Chin J Integr Med,2010,16:368-377.
  • [2]孙锋,陈楠楠,成玉斌.复方黄黛片治疗急性早幼粒细胞白血病204例经验总结.中西医结合学报,2008,6:639-642.
  • [3]Wang L,Zhou GB,Liu P,et at.Dissection of mechanisms of Chinese medicinal formula Realgar-Indigo naturalis as an effective treatment for promyelocytic leukemia.Proc Natl Acad Sct U S A,2008,105:4826.
  • [4]王永炎.增强自主创新能力引领中医药事业发展.天津中医药,2006,23:177-181.
  • [5]张之南,沈悌.血液病诊断及疗效标准.2版.北京:科学出版社,1998:171-179.
  • [6]张之南,沈悌.血液病诊断及疗效标准.3版.北京:科学出版社,2007:103-116.
  • [7]钱林生.复方黄黛片治疗初诊急性早幼粒细胞白血病的Ⅱ期临床试验.中华血液学杂志,2006,27:801-804.
  • [8]刘捷,王海霞,王树庆,等.复方青黛片治疗难治性、复发性急性早幼粒细胞白血病(附36例报告).山东医药,2007,47:32-33.
  • [9]潘登,黄明,时新颖.复方青黛片联合全反式维甲酸治疗急性早幼粒细胞白血病的近期临床疗效观察.中华血液学杂志,2007,20:344-346.
  • [10]郭静明,王海燕,刘红艳,等.复方黄黛片联合化疗治疗初治急性早幼粒细胞白血病的疗效观察.内科急危重症杂志,2007,13:262-263.
  • [11]冯玉虎,黄明,许凌云.全反式维A酸分别联合白血康与三氧化二砷治疗急性早幼粒细胞白血病疗效比较.蚌埠医学院学报,2010,35:709-711.
  • [12]郭明,薛华,化罗明.急性早幼粒细胞白血病缓解后治疗方案的疗效分析.肿瘤,2008,28:150-152.
  • [13]Zhang L,Liu Y,Lu XT,et al.Traditional Chinese medication Tongxinluo dose-dependently enhances stability of vulnerable plaques:a comparison with a high-dose simvastatin therapy.Am J Physiol Heart Circ Physiol,2009,297:H2004.
  • [14]Li XD,Yang YJ,Geng YJ,et al.Tongxinluo reduces myocardial noreflow and ischemia-reperfusion injury by stimulating the phosphorylation of eNOS via the PKA pathway.Am J Physiol Heart Circ Physiol,2010,299:H 1255.
  • [15]Hu J,Liu YF,Wu CF,et al.Long-term efficacy and safety of all-trans retinoic acid/arsenic trioxide-based therapy in newly diagnosed acute promyelocytic leukemia.Proc Natl Acad Sct U S A,2009,106:3342.
  • [16]Soignet SL,Maslak P,Wang ZG,et at.Complete remission after treatment of acute promyelocytic leukemia with arsenic trioxide.N Engl J Med,1998,339:1341.
  • [17]Niu C,Yan H,Yu T,et at.Studies on treatment of acute promyelocytic leukemia with arsenic trioxide:remission induction,follow-up,and molecular monitoring in 11 newly diagnosed and 47 relapsed acute promyelocytic leukemia patients.Blood,1999,94:3315.
  • [18]成玉斌.黄世林教授“驱邪复正”治则治疗急性早幼粒细胞白血病的临床研究.北京:军医进修学院,2008.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn