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。
, U7 L% q3 H1 C+ f4 A  S/ \    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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6 y6 E/ a& k3 p) Z# ~6 c4 U作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
1 m. {: k; [" @6 g6 z6 Y( b! i, aDear Group,

3 s7 l- \+ C# v* d3 h+ tSome 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
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
  y4 M5 P. X% Vremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
does spike up the immune system so I hope more reports come out on this issue.

2 \; @) T- j  a& i+ ~2 ?/ AThe remarkable news about Sprycel cessation is that all 3 patients had failed
- K/ h# z0 k/ s: P& o8 S* _/ rGleevec and Sprycel was their second TKI so they had resistant disease. This is
& e9 r* c" ~5 S# e0 ^- G2 Adifferent from the stopping Gleevec trial in France which only targets patients
: P2 Z6 E9 z  S+ M! vwho have done well on Gleevec.
5 s7 A/ X' B- _) Y& S+ X% P
Hopefully, the doctors will report on a larger study and long-term to see if the
0 ?4 S/ w  T5 sresponse off Sprycel is sustained.

; v4 @5 y. c6 \: J. g7 B- NBest Wishes,
Anjana

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) O+ k0 X4 p$ a  @
Haematologica. 2011 Aug 9. [Epub ahead of print]
# n5 l' }! b6 ?& S* H2 l9 q2 DDurable 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.
4 d, ~* R" P0 J) x) v, b2 \Source
2 {7 n' _6 ~* a: O! U: h9 R, a' KAdelaide, Australia;

Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
6 F! d5 c5 _; D8 P1 X& ]durable complete molecular response might remain in CMR after stopping
; Y4 g' h+ Z4 a; ?! V2 x* mtreatment. Previous reports of patients stopping treatment in complete molecular
* Y0 o$ ^2 [9 L7 Bresponse have included only patients with a good response to imatinib. We
- b5 h  K5 t7 U% q$ N9 [! G0 }0 `describe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
2 j4 G/ d' N/ _* x5 r" [, ~  f+ Qcomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
3 W1 P8 L$ O6 `- J" bshow that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
) l$ u% X9 j, f2 J, l) c. q' Ythe emergence of clonal T cell populations, were observed both in one patient
( \2 x' y( z) x* ^who relapsed and in one patient in remission. Our results suggest that the
! ?$ R; N' o! G7 m) b9 K( }characteristics of complete molecular response on dasatinib treatment may be
+ v# X4 z  y9 y  \& qsimilar to that achieved with imatinib, at least in patients with adverse
( S% J4 I. r6 _* \* p* sdisease 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。

" I, P% J: }5 [0 N作者：来自法国STIM试验
4 o8 r1 m. [1 |8 L* O8 M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