关于停药的相关内容

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。
    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
来源：Haematologica. 2011.8.9.
! `9 S0 a6 c0 ]' q- |1 HDear Group,

9 D2 l  P' ?# M& iSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. Here is a report from Australia on 3 patients who went off Sprycel
6 |% v9 K) t+ Cafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
  W: r7 N# w/ premain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
: F2 N) p5 G! P0 m; q6 B- G4 ~does spike up the immune system so I hope more reports come out on this issue.

  M1 d- L2 [( q7 A' OThe remarkable news about Sprycel cessation is that all 3 patients had failed
; R4 g3 D4 o6 @( V2 eGleevec and Sprycel was their second TKI so they had resistant disease. This is
# g' z  A3 E" Q" L: u% zdifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.

  V; W' r$ N. q- _5 k8 GHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

Best Wishes,
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
  q, c# k9 _0 I# a" xDurable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
/ g! Y2 W8 j9 P& u4 mRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
/ F2 t* ~( s; |( g* YSource
Adelaide, Australia;

Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
; {$ [5 n  E3 Pdurable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
4 v# c5 q/ y, w& V( L5 nresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
+ T  X% c- w( u2 z9 V# K( Ocomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
show that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
3 o! x1 @" x$ X2 [; Lwho relapsed and in one patient in remission. Our results suggest that the
& g) f' T+ b' k- N) d8 kcharacteristics of complete molecular response on dasatinib treatment may be
- G/ ]6 W: ?8 d! g7 ~similar to that achieved with imatinib, at least in patients with adverse
  h# `' J+ y5 @: T. y" [7 B6 ddisease features.

摘要：（STIM试验为法国的格列卫停药试验。）这个研究中，患者先是取得了CMR（融合基因转阴），然后停用格列卫，而后复发。15名复发患者在重新服药后又一次取得了CMR，他们同意再次停药。
    第一次CMR持续时间为31个月，然后患者停药，复发的中位时间为2.6个月，然后重新服用格列卫，中位时间5.3个月之后取得第二次CMR。保持第二次CMR中位时间19个月之后，患者同意再次停药，这次，15名患者中有5名在停药随访中位时间24个月后仍然保持了CMR，而10名患者在停药中位时间2月后第二次复发。
    请注意，这些患者都是在第一次CMR后停药然后又复发的患者。

作者：来自法国STIM试验
! \+ _# r6 ~; T来源：EHA 2011.6.会议摘要

很不错的文章，看来马老师家有考虑停药的想法了啊！祝福！

期盼易或特也能停药，但现在觉得是一个梦想！

这个非常有意义的研究。能吃下来停会再吃，再停，那是天大的好事