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。
" j% A6 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。

作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
# Q1 l( B/ t7 N. q3 t7 n# ]7 yDear Group,

: N1 i0 J- B4 v& H) _  m2 `4 X+ LSome 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
; A) }8 M( C. O& \% a  U. X: Rafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
) n* O( T. z/ l/ S6 tremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
+ k- x! ~" p" C5 T7 d9 F+ Cdoes spike up the immune system so I hope more reports come out on this issue.

The remarkable news about Sprycel cessation is that all 3 patients had failed
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
  u8 x& g/ v$ c6 O" l6 Kdifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.

4 E; w) E, f& h" D  a1 RHopefully, the doctors will report on a larger study and long-term to see if the
/ P3 e, v3 z4 Jresponse off Sprycel is sustained.
# _- P, n9 w3 v, c
Best Wishes,
Anjana



" {% U: Z# m3 E' `% m7 SHaematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
! ?8 ]- p1 G6 I  ~: P* H5 S0 Q; pSource
! Q) G+ S6 ?- y$ K3 B8 I$ bAdelaide, Australia;
4 X1 x) \) S0 k( G  w/ ]
1 T" N; s* O* [4 \( I0 bAbstract
6 G3 e4 U6 t5 f( o$ GPatients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
9 B# z5 Q4 J! R3 Uresponse have included only patients with a good response to imatinib. We
& d$ @( ]* P, N4 tdescribe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
. |$ w- R6 x, A7 k4 z2 ycomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
# u0 \9 X* n+ j- o  P7 w' ^' M4 xshow that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
, F4 P- r" V8 N+ h! Q3 Q2 g8 K' w( Ythe emergence of clonal T cell populations, were observed both in one patient
5 d9 Y5 Y+ r5 p7 ?+ `who relapsed and in one patient in remission. Our results suggest that the
  N9 P% H1 H7 Hcharacteristics of complete molecular response on dasatinib treatment may be
% n$ o- ^; z/ J" N: w, O7 b/ psimilar to that achieved with imatinib, at least in patients with adverse
' Q" S+ Q2 B+ [% h, T" Odisease features.
$ O* ^( c0 C) J! U& n

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。
9 s" _7 x0 X4 i- S4 p
9 M; L' _  j$ k5 J% G, _& U作者：来自法国STIM试验
$ B4 @" o, n# B: L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