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。: y* ^1 V( ]2 i5 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。
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作者：来自澳大利亚. c2 m. q& w1 q3 N0 p! J# [
来源：Haematologica. 2011.8.9.9 q2 j8 F. W4 q5 E8 i, a: t( Q
Dear Group,
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! z- i0 r. K Y3 S" sSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML' I/ x" J p+ c6 U8 V" b
therapies. Here is a report from Australia on 3 patients who went off Sprycel1 H! [% @* @7 B) N. o( d
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients' Q* c+ A( Z/ `
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
8 R5 B# }- M" R$ w+ ?does spike up the immune system so I hope more reports come out on this issue.% Y* I; }. X2 r8 ^/ p1 T
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The remarkable news about Sprycel cessation is that all 3 patients had failed
3 p, r" _: ]7 j. U, W. a9 pGleevec and Sprycel was their second TKI so they had resistant disease. This is
0 v: _; V) l6 l: gdifferent from the stopping Gleevec trial in France which only targets patients- v' M* ~$ G# q1 A) X
who have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the
+ h* e$ _5 t4 |: b/ \response off Sprycel is sustained.; N( a: [) _/ t) f4 m. a# Q
! V4 j: T" k! b4 z2 sBest Wishes,3 B7 J' O4 [/ B, p, ]
Anjana( e% F% h6 p* f& {/ y
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Haematologica. 2011 Aug 9. [Epub ahead of print]0 I7 e( e) T a! R2 }, X, y% I3 i9 g
Durable complete molecular remission of chronic myeloid leukemia following
4 g6 Z2 r% T8 L# H7 K- Ydasatinib cessation, despite adverse disease features.
8 {$ V' o# w- ?3 S0 fRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
6 _' B+ H H2 X# f# @0 ]0 O6 F& bSource: |% C$ k7 U; H
Adelaide, Australia;
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2 P$ [& u/ X i& N0 b4 Q/ R3 l, AAbstract; N. s6 @3 B2 n
Patients with chronic myeloid leukemia, treated with imatinib, who have a
( @+ |) i( q$ E- T& q! t$ qdurable complete molecular response might remain in CMR after stopping
1 C% s1 t' |5 ntreatment. Previous reports of patients stopping treatment in complete molecular
3 j* o6 j1 u4 C' @6 m: Dresponse have included only patients with a good response to imatinib. We
) h' X7 ^* @- E% O5 H Gdescribe three patients with stable complete molecular response on dasatinib
# V) R4 m8 F; Q' u x+ Etreatment following imatinib failure. Two of the three patients remain in0 s+ Q+ w0 K, G, Z
complete molecular response more than 12 months after stopping dasatinib. In
1 h( r1 x% n& B6 ethese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to% b7 K0 f9 e' i0 f' l% a3 @
show that the leukemic clone remains detectable, as we have previously shown in
& h% u9 b0 Z; L6 {imatinib-treated patients. Dasatinib-associated immunological phenomena, such as1 H! H4 K- u! C# P& }* G. t! \ Q. N
the emergence of clonal T cell populations, were observed both in one patient
' d0 U; O# G% Pwho relapsed and in one patient in remission. Our results suggest that the
7 V4 R) W7 m1 H0 C o' Z2 K6 L6 Lcharacteristics of complete molecular response on dasatinib treatment may be. V- M9 N; N* Y: E' h. f4 p
similar to that achieved with imatinib, at least in patients with adverse
+ T9 Q! D$ ]4 W: p$ Hdisease features.+ \8 ~% Q. v$ S0 B" C2 g9 Z
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