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。
+ X1 o1 o2 ~1 k$ y, E; D 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。5 ?. M5 R5 i( {; R- Q1 i) ?* }
n- u4 e! P* Q( m# X$ p' T) H作者：来自澳大利亚" h8 j( s3 J5 ]* @3 f
来源：Haematologica. 2011.8.9.# a$ T5 c- I) @1 H3 I* S
Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
& N, X& L2 E& B6 k! H' atherapies. Here is a report from Australia on 3 patients who went off Sprycel
1 M9 z4 t4 |! S& h* `after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
. e( q1 `* r9 m* A" X3 [2 premain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel& s6 h! L, J! ?5 A" G, n9 U
does spike up the immune system so I hope more reports come out on this issue.5 a0 Y B# A8 l7 _& G
! z& U7 D2 f% M8 ZThe remarkable news about Sprycel cessation is that all 3 patients had failed
8 A# \& Y; t% g, ~Gleevec and Sprycel was their second TKI so they had resistant disease. This is3 ^1 Y6 B4 e& A2 X
different from the stopping Gleevec trial in France which only targets patients: Q9 m5 Q( u( ~% z- t# s
who have done well on Gleevec.
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B" O. J2 [) h' C7 k+ e2 A) V- EHopefully, the doctors will report on a larger study and long-term to see if the' q' A; z9 R" ~& ]. _8 ^/ P& X+ \" o
response off Sprycel is sustained.
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Best Wishes,
; t4 V" U5 |" ~7 V: q JAnjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]% q' s: t5 k7 e. X
Durable complete molecular remission of chronic myeloid leukemia following
3 S( ]5 l( v& p/ W$ d [dasatinib cessation, despite adverse disease features.* k W- h7 ~$ u r7 ~2 A7 d
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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Adelaide, Australia;+ I3 E9 m/ w! {$ A; r4 V
$ V! G% @8 t/ tAbstract
2 n' v( }. Q7 I2 F* zPatients with chronic myeloid leukemia, treated with imatinib, who have a* e+ O0 H& H$ f, Q9 j V( e5 C1 w
durable complete molecular response might remain in CMR after stopping5 @4 f" w i2 c& G3 f0 z t
treatment. Previous reports of patients stopping treatment in complete molecular
9 s @ Y6 m6 b7 k' ]response have included only patients with a good response to imatinib. We% C- z; s2 t$ y& L8 F" }; C
describe three patients with stable complete molecular response on dasatinib6 s1 _1 b7 q( v% U2 G& E' A2 @$ w) b
treatment following imatinib failure. Two of the three patients remain in
. @& e& E3 o' N0 ~complete molecular response more than 12 months after stopping dasatinib. In6 O0 l4 e" L3 ]9 y& q& J
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
5 q+ ^$ f+ i: Y6 jshow that the leukemic clone remains detectable, as we have previously shown in& L3 Q+ F6 y+ I/ {
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as3 ~" |8 ^. H6 H" C$ N
the emergence of clonal T cell populations, were observed both in one patient& f L5 q4 {0 f! Y- P
who relapsed and in one patient in remission. Our results suggest that the
3 i9 j1 A0 B6 l3 l. vcharacteristics of complete molecular response on dasatinib treatment may be, e3 T' }, _; X7 d- ^
similar to that achieved with imatinib, at least in patients with adverse8 `+ C8 ~1 Y# V: a' N8 G0 S. L- f
disease features.
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显身卡
