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。" q) ]6 j- N' h# L, [; \
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。4 y$ }9 e" f2 {7 O/ U. e3 X2 b
( `) A! y1 i" ~9 a3 Y9 q- I' V! l/ x作者：来自澳大利亚
! \) U- `" O+ y) r2 L来源：Haematologica. 2011.8.9.+ @; u/ K7 b+ u) w f
Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
$ I4 ?. z3 Q# S0 ktherapies. Here is a report from Australia on 3 patients who went off Sprycel) |0 V- ?" Q9 l2 @5 H4 ?% B
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients/ v0 W& _4 a$ @ @- ]7 m# w
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
' E6 e+ g a) fdoes spike up the immune system so I hope more reports come out on this issue./ O! U {' {8 u( c; _0 ]8 P
' f1 H; g" Q _$ t! t6 ~2 W) hThe remarkable news about Sprycel cessation is that all 3 patients had failed }2 V4 j' A, U+ ]6 u
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
$ k& C1 L7 j, \. k$ }5 J; e( @9 Rdifferent from the stopping Gleevec trial in France which only targets patients
- H5 ^$ Q0 m! N/ v/ V/ x7 jwho have done well on Gleevec.
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" y5 c0 ^+ [: \8 H6 P! fHopefully, the doctors will report on a larger study and long-term to see if the
$ V6 N t( N0 E* S. Oresponse off Sprycel is sustained.4 k" ~$ r2 e7 x9 \0 b6 U+ M X
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Best Wishes,8 H5 D Q/ |" ]: \8 F
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
( h' z/ i$ q! I* N1 FDurable complete molecular remission of chronic myeloid leukemia following
9 n- @& F2 U" k4 }% n: sdasatinib cessation, despite adverse disease features.' M( F- _. N/ J/ C2 Q; B
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.+ a+ g% q } B1 H3 a* w; R0 C
Source
( y9 [6 b5 W9 g* e @Adelaide, Australia; N7 s1 B+ |# J& K6 w* Z3 I* Z+ N
! k) l( E6 f4 `% ZAbstract
$ D7 Z& O# a/ _, g0 oPatients with chronic myeloid leukemia, treated with imatinib, who have a
. c# \( N5 \* |- ^durable complete molecular response might remain in CMR after stopping
- h- X9 y( h* J0 a8 O& ftreatment. Previous reports of patients stopping treatment in complete molecular
+ l9 J+ }5 ?# `response have included only patients with a good response to imatinib. We4 V1 Y. o a @
describe three patients with stable complete molecular response on dasatinib: n& h2 g! u' Z0 d+ C% _8 n
treatment following imatinib failure. Two of the three patients remain in
. ~( X" P' ]0 g' A; [4 qcomplete molecular response more than 12 months after stopping dasatinib. In3 \/ B# r+ x! U6 ?9 O1 X; N- c1 L
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to$ C+ T4 _+ u- W& c
show that the leukemic clone remains detectable, as we have previously shown in7 k6 g8 y- p! x! `! z% t9 T2 z
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as0 ~- A8 H q3 A
the emergence of clonal T cell populations, were observed both in one patient
5 D3 b6 f L# wwho relapsed and in one patient in remission. Our results suggest that the/ w! O( [- F. Q+ ?/ v, \1 [& V
characteristics of complete molecular response on dasatinib treatment may be
# |* F& A: j2 m" U( ysimilar to that achieved with imatinib, at least in patients with adverse
' Q" Y! S9 x9 S7 n5 Mdisease features.7 W6 J$ l$ b8 J4 T
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