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。& }6 R p5 F6 Y l" a
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* n( Y0 \, Q& Q( q4 F/ q9 c
来源：Haematologica. 2011.8.9." y8 c2 G7 y( X" c0 ] R
Dear Group, q' t/ T) M6 U4 ~: q9 `- ]+ U
- z2 l. p3 B& i: c9 J' R, ?Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML0 F }8 a: \+ p- v0 g
therapies. Here is a report from Australia on 3 patients who went off Sprycel3 Y$ r/ W- }7 t" B: T% y
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients. \! _7 b* `" t9 }) {3 N
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel; Q6 }1 x' K. y+ I: i
does spike up the immune system so I hope more reports come out on this issue." t l2 R2 X; A" c8 X/ @$ J
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The remarkable news about Sprycel cessation is that all 3 patients had failed8 S9 W8 h. P: W- f
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
' y, I+ T/ D, K0 `different from the stopping Gleevec trial in France which only targets patients
, W6 ?1 N! C3 p' K8 b ` Pwho 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& J3 n( z0 W( y
response off Sprycel is sustained.$ q( d; `5 ]. L% x' c$ l3 t
$ m; h2 |. v$ L7 T& [5 O% L* C6 uBest Wishes,7 l, J5 t; S9 ^
Anjana
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5 r2 X- h1 X6 L7 ]( PHaematologica. 2011 Aug 9. [Epub ahead of print]
3 B# ], p& C; P2 @1 bDurable complete molecular remission of chronic myeloid leukemia following* S+ o9 a; J; N' I% J! R+ F4 h
dasatinib cessation, despite adverse disease features.% J) B& x8 }, G( d
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.& M3 `: t% [2 ^/ K. E1 ^7 g. }9 L
Source
1 i( U c* \6 s& b7 gAdelaide, Australia;9 D! U; t/ F4 F% q3 V$ z
0 w' X2 V; q+ ]* Y+ y0 z& }Abstract _9 _2 i' k- }* N, N
Patients with chronic myeloid leukemia, treated with imatinib, who have a
0 j% S6 p' T8 ?4 qdurable complete molecular response might remain in CMR after stopping6 l, r& P8 H9 M2 x: h' C* L J z
treatment. Previous reports of patients stopping treatment in complete molecular
2 X" Q7 q, }0 n! Bresponse have included only patients with a good response to imatinib. We* t( }3 z5 R5 N% P' A% T
describe three patients with stable complete molecular response on dasatinib
5 X2 C5 A2 w% L9 J2 X0 gtreatment following imatinib failure. Two of the three patients remain in# P) g( q f5 g( u: y1 J
complete molecular response more than 12 months after stopping dasatinib. In6 j8 m/ @2 ?- ^" T4 Z( F* V1 v5 M" u
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
# o" q1 y- h8 t4 G7 t9 S% p2 Cshow that the leukemic clone remains detectable, as we have previously shown in
2 x% b. ]( `! [9 Bimatinib-treated patients. Dasatinib-associated immunological phenomena, such as3 y" W1 D6 z1 B# y7 a
the emergence of clonal T cell populations, were observed both in one patient h" ~9 e+ g- z( _, I3 ^
who relapsed and in one patient in remission. Our results suggest that the
# |8 p1 W* u Y1 T1 o7 ?" P2 lcharacteristics of complete molecular response on dasatinib treatment may be# l2 y( d1 c' @. {3 g
similar to that achieved with imatinib, at least in patients with adverse
' }; b3 T% `( X4 d1 L3 I. Adisease features.
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显身卡
