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。
& }& Z" @9 T9 c" e 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。. k7 E8 F8 P# Q& x3 L
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作者：来自澳大利亚
6 R8 K/ p, E% h3 j5 i5 P4 o& ^来源：Haematologica. 2011.8.9.. ?& C8 H8 ~% x |; h
Dear Group,1 N) D' |3 Z6 Z9 p7 R" U) d
+ b% s# Y9 k& D5 _Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML# @! M, @5 p# j4 q
therapies. Here is a report from Australia on 3 patients who went off Sprycel8 t& d1 Y( q6 W$ f7 Y9 O! O. Z
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
?% \7 E% q' N9 y) Yremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel# E% j0 Q" Z- X9 w
does spike up the immune system so I hope more reports come out on this issue.& d6 w* \# L; ?7 a$ o% u
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The remarkable news about Sprycel cessation is that all 3 patients had failed
. A" R1 n; s# o; o$ Q0 K4 O+ ?8 qGleevec and Sprycel was their second TKI so they had resistant disease. This is
3 H& o7 I n0 h, w; p. ndifferent from the stopping Gleevec trial in France which only targets patients
% x6 J' }, H: w! D* w) zwho have done well on Gleevec.
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: P* e6 G+ M# ?% s) fHopefully, the doctors will report on a larger study and long-term to see if the
: M8 O- a! H. _& ~! gresponse off Sprycel is sustained.5 Q5 C3 _% ^8 G1 F6 x
' ~+ b0 S0 ~7 ^! r3 e" z/ }Best Wishes,; L8 |' k( V& v/ M% C2 K
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]1 _1 |+ @! u6 {1 ~
Durable complete molecular remission of chronic myeloid leukemia following
6 b- w' s; |' v, q) ~dasatinib cessation, despite adverse disease features.
9 r0 r. Q( y6 xRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP./ U; k4 Q5 @7 @& E* ]) d
Source d, p% `+ n& H/ j/ P; W
Adelaide, Australia;4 X" `0 R. m3 R0 ^# I7 V
r' i8 G) C9 Z$ MAbstract
8 y8 w6 Q" k U _! qPatients with chronic myeloid leukemia, treated with imatinib, who have a& X# L+ _& K: c
durable complete molecular response might remain in CMR after stopping; w) r5 [9 q4 H# L8 k- s+ a4 _
treatment. Previous reports of patients stopping treatment in complete molecular" m! c/ d% ~, L1 j4 H
response have included only patients with a good response to imatinib. We
6 }4 s: Q' R6 }) A6 G' W5 ^describe three patients with stable complete molecular response on dasatinib
3 S, @5 ~- f2 B; V* u% x- Rtreatment following imatinib failure. Two of the three patients remain in
7 ?, T$ V w3 g# E4 l) e7 L' x) r& lcomplete molecular response more than 12 months after stopping dasatinib. In
, ?/ W# A2 P- P7 x. L- {) }, |4 bthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to5 b& Y( x0 W, Q( d% H, Q( O
show that the leukemic clone remains detectable, as we have previously shown in1 V1 X2 t* G. ?; E" O
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
+ _0 R; I6 ]+ D L0 l1 Mthe emergence of clonal T cell populations, were observed both in one patient. x v s* V7 O# Y% y
who relapsed and in one patient in remission. Our results suggest that the) \3 o/ }/ a0 ]) R8 V3 @6 V
characteristics of complete molecular response on dasatinib treatment may be
: A, x$ m) J/ l* Z1 ~; d/ r" ysimilar to that achieved with imatinib, at least in patients with adverse
6 `( k# H8 D7 c" idisease features.% i f5 b9 p- c- E7 n
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