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。
    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。

作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
0 t8 s7 q, T0 Q" L* E6 p, f* E7 j5 RDear Group,
0 h8 z5 q7 F. _( i& a6 x
8 ]! i) t2 U% Q+ Y4 ZSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
4 \& P* ~( j6 ftherapies. 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
remain 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.
6 m8 {( V$ I& c1 G) T+ w0 ]
The remarkable news about Sprycel cessation is that all 3 patients had failed
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
( v" `! Y/ `) l; n7 P, n# Udifferent from the stopping Gleevec trial in France which only targets patients
3 p1 V( ]  a) \- U; _who have done well on Gleevec.
! e2 |# }& E5 h1 H( U3 `) q
' P5 s7 b4 |( xHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

; G  z+ P. l; M& P2 F" VBest Wishes,
+ e0 y, m+ N5 i* k7 wAnjana
: @  C, m( r) ^. X+ P) e


; E+ ]- r5 G6 P0 oHaematologica. 2011 Aug 9. [Epub ahead of print]
9 C6 }+ N  r9 T) C% `1 j  f  U* yDurable 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.
Source
) |' a; i# W) @+ Z; n: P( h4 mAdelaide, Australia;
. M2 K; ^+ ]& z1 ]+ f" {0 X
  s1 C+ ^; x; \% z3 w$ lAbstract
) e  u6 e0 V: X/ T# E4 kPatients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
' o1 {  D, M  }( O+ rtreatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
5 X0 N0 j( R# P' Jdescribe three patients with stable complete molecular response on dasatinib
& L# P2 @. @$ @) |% h5 ytreatment following imatinib failure. Two of the three patients remain in
" \8 ?( f' W: w# Zcomplete molecular response more than 12 months after stopping dasatinib. In
# r, y' I0 U+ W/ A0 M8 p' |: Wthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
. \+ E& o! R/ c0 y" r9 \4 v1 k& ^show that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
+ v) s6 d: C% \0 {the emergence of clonal T cell populations, were observed both in one patient
# E. W2 n, }2 |( f8 y5 C9 Xwho relapsed and in one patient in remission. Our results suggest that the
characteristics of complete molecular response on dasatinib treatment may be
( Q% u; _6 t  b) J$ Rsimilar to that achieved with imatinib, at least in patients with adverse
3 O  F6 B2 k+ Bdisease features.
( _4 v$ E# X* y" q9 {7 d

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。
  r* p, v( t( B  g$ ]- ?    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。

2 G. t4 v) g) D  \2 X作者：来自法国STIM试验
6 N. E  b' S0 }3 ^) h0 \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