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。
: @7 Q# F. w) \& ^7 h    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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# O! l8 Y7 {8 K9 z9 G作者：来自澳大利亚
4 Q& S9 Z7 t0 O: C1 \; L( i9 ^来源：Haematologica. 2011.8.9.
Dear Group,

Some 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
) l  v1 z9 `3 g( A- a* c6 L; Fremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
  V9 ~2 i; A1 D# A& i* k7 E; kdoes spike up the immune system so I hope more reports come out on this issue.

The remarkable news about Sprycel cessation is that all 3 patients had failed
8 ?/ m9 W8 b) L, J; @Gleevec and Sprycel was their second TKI so they had resistant disease. This is
. ^* ^2 B. l, D2 ldifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
: O+ f8 @1 S& \8 K' q# _( i
Hopefully, the doctors will report on a larger study and long-term to see if the
% R$ t7 d0 K/ q' t9 v; |6 W% o$ ]response off Sprycel is sustained.
; P& ~& E2 j& z1 L8 N5 |$ {
6 h( c5 R8 E' ^1 C) j# u0 [9 vBest Wishes,
Anjana


5 ]7 j' X! H5 ~: [, ]
9 r4 }7 X. S6 zHaematologica. 2011 Aug 9. [Epub ahead of print]
& j0 t  Y" F' r3 f) w& R$ ]Durable 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
Adelaide, Australia;
$ ^8 X) T6 h* @9 o
Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
8 ^& b1 n0 s; tdurable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
9 |& N4 E3 j! h: _" |5 C+ a! uresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
" n: |, F& [5 \& a0 a% n% Lcomplete molecular response more than 12 months after stopping dasatinib. In
# T6 x7 N4 w/ B  Rthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
5 ^1 r: _7 k  A% m# o0 Rshow that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
who relapsed and in one patient in remission. Our results suggest that the
& T1 B- a6 S& x$ N1 c/ W8 l% u: Rcharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
$ s4 c- K0 s' O* Z3 X* `5 l/ Zdisease features.
& |$ Q8 h  i: {; E7 k0 }: s" [. J

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。
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" o3 h$ R- t! G- i作者：来自法国STIM试验
1 c/ u1 X. c# O+ m0 ?/ l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