摘要：这3名患者在取得稳定的分子学缓解之后（融合基因转阴PCRU）停用达沙替尼。1名患者复发，另外两名患者在1年后仍保持了PCRU。以前说过，达沙替尼确实可以提高免疫力，希望今后能获得更多的相关研究报告。
) H8 X, E( O" r( K7 Q0 p* } 关于这个研究值得注意的是，这三名患者都是服用格列卫失败后转用达沙替尼的，也即他们对格列卫是耐药的。这与法国的格列卫停药研究又有所不同，那个研究中的患者都是对格列卫反应良好的。希望医生们能扩大研究长期观察，看看停用达沙替尼是否能持久不复发。
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作者：来自澳大利亚
, V4 i! W" B( k& |5 x1 Z来源：Haematologica. 2011.8.9.9 R' i1 Y$ [! U$ D# O6 K
Dear Group,4 V) d) F: F1 G$ Z$ b& x; }
5 h* D: A" J& T) r; p- p1 RSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML4 ?4 J9 p" v% K! Z8 G0 i7 C0 \
therapies. Here is a report from Australia on 3 patients who went off Sprycel) |; ]% `/ i8 |4 O# Y6 ^
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients# ^2 F2 [# Z; L5 Y5 y' m6 n _+ r3 l p
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel3 M W1 @- m; W9 \9 K& v. C
does spike up the immune system so I hope more reports come out on this issue.
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3 s I, ?# p7 G+ n" O, G' ~0 ^The remarkable news about Sprycel cessation is that all 3 patients had failed; a" d* r9 b K8 e6 e: c
Gleevec and Sprycel was their second TKI so they had resistant disease. This is& _4 t- a1 Z" f: A ]) p
different from the stopping Gleevec trial in France which only targets patients/ C! Q9 k7 V7 N8 S% M1 _6 @' h( ]: o
who have done well on Gleevec.
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7 k' p/ D G* l$ u( H; n% \ lHopefully, the doctors will report on a larger study and long-term to see if the
2 k! Y' E6 L$ L9 Z x* Aresponse off Sprycel is sustained.1 L' f" t5 k1 _- H0 n+ W8 F
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Best Wishes,) U/ { C% y! Y/ U0 V; W; Z5 y
Anjana
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1 w P- l% ~8 O+ l Z; iHaematologica. 2011 Aug 9. [Epub ahead of print]. a G8 n j- y4 Q4 P# {, B
Durable complete molecular remission of chronic myeloid leukemia following
3 P. K \: p% [& gdasatinib cessation, despite adverse disease features.
# i; c s: ~' j# y, jRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
, ~ D3 N; L' f) BSource- O# t) A5 s u, A
Adelaide, Australia;
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* v' K3 y- C) p: O {Abstract! [% b% Q( F. ]! E/ n' @
Patients with chronic myeloid leukemia, treated with imatinib, who have a
~( x9 S- F7 g' G* Zdurable complete molecular response might remain in CMR after stopping1 P8 K+ [4 M. Z* I) s* x% n
treatment. Previous reports of patients stopping treatment in complete molecular! ]; j! v+ D# ^, s
response have included only patients with a good response to imatinib. We: a! ?5 O' l( ]4 d9 S
describe three patients with stable complete molecular response on dasatinib
' P0 A4 D1 K2 a7 V7 `. f" _" \4 itreatment following imatinib failure. Two of the three patients remain in, _6 Y7 O4 [2 s+ k6 v
complete molecular response more than 12 months after stopping dasatinib. In; e6 M! S+ d+ _" n+ n. k
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to! b. }0 s$ X; r; } s
show that the leukemic clone remains detectable, as we have previously shown in
0 P3 v; {; D$ a- e) w! nimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
3 H% [3 O! j0 gthe emergence of clonal T cell populations, were observed both in one patient
$ `6 p2 {. n) E8 G( e; J; E8 zwho relapsed and in one patient in remission. Our results suggest that the& [* C" V1 t, T" F) g2 z8 I- O" @
characteristics of complete molecular response on dasatinib treatment may be
+ W+ c" a X' \5 `7 w1 {0 e$ usimilar to that achieved with imatinib, at least in patients with adverse/ _6 F/ m0 N9 P0 Z- w# q; {3 X5 b
disease features.
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