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。
/ [2 Z7 [& h- A/ r r 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& U; L2 H" d8 Z$ E- y来源：Haematologica. 2011.8.9.+ v& o, ^/ {% ^
Dear Group,# }6 ^( c9 ]& G9 S3 k, ?% ^
1 {( l- P9 S1 B! Y' V1 u# @Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML0 E% Z, a. o4 a5 S7 f' e$ w h
therapies. Here is a report from Australia on 3 patients who went off Sprycel) _) Z3 _0 P$ j5 a" C5 w
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
+ W& Y( w' d- N: `remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
; x# h3 f# p2 c1 [does spike up the immune system so I hope more reports come out on this issue." l, ]! ?" r, F r7 a2 c- F, ~" v0 [
, [2 q; F0 P+ w" Y+ LThe remarkable news about Sprycel cessation is that all 3 patients had failed
1 D- _8 b; C% {: PGleevec and Sprycel was their second TKI so they had resistant disease. This is5 Y4 `1 n a2 u. M
different from the stopping Gleevec trial in France which only targets patients
% N6 T) N- T" X/ Ewho have done well on Gleevec.* D1 ?0 l0 \2 {) j1 L7 l" Z
& y$ |3 k- t7 O! Z* x7 bHopefully, the doctors will report on a larger study and long-term to see if the
7 R9 B. q; o* _2 m5 H2 s4 Q% ]response off Sprycel is sustained.6 z2 [, O l' E% }8 t* T B9 A
* D4 @6 I' a9 w% j. D6 S. r( e; {
Best Wishes,
$ F0 Z2 C& T; RAnjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]. Q5 i- T _. q' z) t. d
Durable complete molecular remission of chronic myeloid leukemia following2 T2 u0 Y. W& q/ i- ~/ _0 T2 t
dasatinib cessation, despite adverse disease features.
2 ~ _! x7 G2 M: mRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
6 t4 [# h4 `8 c8 }Source( t! x6 d' R3 P8 X
Adelaide, Australia;- M: p% E6 w- f: W
# @% S/ Q- |- D0 m d& mAbstract
5 k8 W! P) e- G B- a8 \Patients with chronic myeloid leukemia, treated with imatinib, who have a' h9 s7 ?+ Q3 ]; L/ \' y
durable complete molecular response might remain in CMR after stopping: T" ]" u: V% f, U& `
treatment. Previous reports of patients stopping treatment in complete molecular; d$ d' H( i0 l% \1 H- [% k
response have included only patients with a good response to imatinib. We3 w2 v8 z0 _8 f% q. q5 A& |
describe three patients with stable complete molecular response on dasatinib
( }. w, ]# [0 f: K0 Q1 A& etreatment following imatinib failure. Two of the three patients remain in/ I( C( Q; m2 [; V
complete molecular response more than 12 months after stopping dasatinib. In
7 a( t% T' O/ Y' p* S9 lthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to8 G. w8 l/ R2 s% z5 _0 J! r$ h6 T
show that the leukemic clone remains detectable, as we have previously shown in
' v& u% m5 J$ t: P* Timatinib-treated patients. Dasatinib-associated immunological phenomena, such as* T# s5 } q; ~. w( d
the emergence of clonal T cell populations, were observed both in one patient
( i. Y- O9 Z1 m/ i2 pwho relapsed and in one patient in remission. Our results suggest that the
4 v0 o, u: U6 I" J* Vcharacteristics of complete molecular response on dasatinib treatment may be* k$ ~7 W5 ?4 A7 Q$ F& q% j
similar to that achieved with imatinib, at least in patients with adverse
- c0 b) S* [" s* Zdisease features.
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11011102001537 )
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