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。
1 t" Q2 e  T) ~) a9 B. W8 ^% `    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。
' `  y) P5 S/ o" E
作者：来自澳大利亚
8 A! I$ Y- \2 ]/ b8 c/ Q  N来源：Haematologica. 2011.8.9.
8 y* q  K% k; S: B9 ~Dear Group,

3 i( n3 b# y- Z7 K6 sSome 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
. U% v  v2 ]$ ]0 Z2 K! t; w. Jafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
8 i& c- w1 B( ^% t" Qremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
5 Y, W& y, m" Q- e7 s4 u$ ]does spike up the immune system so I hope more reports come out on this issue.
( q' Y! p1 }9 N: E# [9 b
! y5 L, ~2 f( _& uThe 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
: E; P# R* `. C' j. s" bdifferent from the stopping Gleevec trial in France which only targets patients
4 I6 U; X. u1 E2 [/ b& p$ P1 k. z+ }who have done well on Gleevec.
% q+ D# Y0 W; q6 D/ b! {
/ Q; Q; t6 e  X# t! K( uHopefully, the doctors will report on a larger study and long-term to see if the
" d2 X" V9 s% l! }! H) ~$ oresponse off Sprycel is sustained.
& G' Q, `8 E7 _5 ^# G6 E
! R, S+ ]$ \$ A" SBest Wishes,
Anjana
: N7 x. H# k1 N; e/ O6 I
8 V; Y9 Y+ g) C$ {

Haematologica. 2011 Aug 9. [Epub ahead of print]
% D  n- Z3 A8 ]7 SDurable complete molecular remission of chronic myeloid leukemia following
4 m( Y9 a' a( X; Q! ldasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
Adelaide, Australia;

2 \5 M4 a: ~5 u! j7 `3 wAbstract
! m/ v2 s- v* ?Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
! @% [1 I. [4 ?5 ^treatment. Previous reports of patients stopping treatment in complete molecular
6 \% q" e- e! Nresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
/ I$ Y, i7 [- j* Z  @0 X( wtreatment following imatinib failure. Two of the three patients remain in
* F4 `' a! n9 ocomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
1 i" Y4 M3 g0 x" x* k  Qshow 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
5 V$ ~8 c& s; x9 p% u1 m+ I, ?5 Uwho relapsed and in one patient in remission. Our results suggest that the
. v  g% \& V) n1 K8 m0 rcharacteristics of complete molecular response on dasatinib treatment may be
& T0 F& c7 V9 T- L3 E" Gsimilar to that achieved with imatinib, at least in patients with adverse
0 [/ K% k* J) L: X+ A6 |. T, Cdisease features.

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。

. b6 A% M9 o' \1 i: O作者：来自法国STIM试验
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