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。
8 W0 K, R& k c+ v8 g o 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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: T ~* \& Z7 Q1 I' e7 ?作者：来自澳大利亚3 j- b5 ?% X/ D, u9 F
来源：Haematologica. 2011.8.9.% }9 Q2 I6 ]( [) E" c
Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
9 E1 S+ l+ G* q/ T5 S W/ |4 b4 mtherapies. Here is a report from Australia on 3 patients who went off Sprycel
7 e, Z* P" _; @5 s* v$ _after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
& V b7 `$ B. N% \" ?remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel' I1 g. X8 Q" t/ _7 Q: G% ?
does spike up the immune system so I hope more reports come out on this issue.
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2 F5 |7 n' Y& G3 P" }% x/ z2 ?The remarkable news about Sprycel cessation is that all 3 patients had failed. P$ k3 d" y" X* a% D9 l% C
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
. u- ~# G, M- J+ }4 Cdifferent from the stopping Gleevec trial in France which only targets patients
" p7 w! f' ^0 o! p3 A5 P+ D Vwho have done well on Gleevec.( m, y f% ~% D j
# Q: f$ B6 D2 G+ R' i+ o' OHopefully, the doctors will report on a larger study and long-term to see if the% ^8 m' e2 }+ f, i, f# j" g9 s( W
response off Sprycel is sustained.; X7 W4 |/ W+ t4 U
P6 M2 q- D% o* ^3 J
Best Wishes,
( U1 ], h, E: G! }Anjana; m5 ^& _& ~6 R ~5 Z
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( r- b! x0 d7 W. D: o) dHaematologica. 2011 Aug 9. [Epub ahead of print]1 `! t- f0 ?5 L1 E) g1 S
Durable complete molecular remission of chronic myeloid leukemia following
! f" h% H, `# I* C) i+ b, Odasatinib cessation, despite adverse disease features.) c- x2 w5 z6 b* D
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
) [6 H9 h* C% rSource: O, f/ z$ _( O) C
Adelaide, Australia;$ A2 a: a8 _" A: o7 w
! g3 J' B% B1 ~; O3 D$ ?Abstract0 k: ]$ @# {" ^1 |
Patients with chronic myeloid leukemia, treated with imatinib, who have a
% k9 ?7 N3 x& n P6 x+ ^) b* ]durable complete molecular response might remain in CMR after stopping+ H5 C; S: o/ y- ~, L( O# I
treatment. Previous reports of patients stopping treatment in complete molecular+ g& S- `6 z! [/ L4 y- q
response have included only patients with a good response to imatinib. We" G& T' G4 }1 j# u: ]- M
describe three patients with stable complete molecular response on dasatinib
' D( j! {; b/ ]6 l" etreatment following imatinib failure. Two of the three patients remain in: |4 F! R2 N ^2 P. t; I. a& Q4 W
complete molecular response more than 12 months after stopping dasatinib. In
# t7 P( J3 e' a E# G: [4 S/ G4 E0 dthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
1 [) W/ x/ n8 K& V$ m; R4 Gshow that the leukemic clone remains detectable, as we have previously shown in. Y7 Z# p7 C+ x
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
3 m/ q# P+ e5 |& _5 ]/ T2 @the emergence of clonal T cell populations, were observed both in one patient
' a, g/ {7 [9 b: f* s# cwho relapsed and in one patient in remission. Our results suggest that the
* Q/ B2 G6 n! R- I. K" Icharacteristics of complete molecular response on dasatinib treatment may be7 }0 O5 \* }5 F; S
similar to that achieved with imatinib, at least in patients with adverse
- p) i8 f3 C d Q3 xdisease features.
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显身卡
