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。
+ r5 L6 G8 m9 V, B' D! b- T 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。9 D9 B5 M0 r6 v
1 ^0 e! g4 S3 ^' G/ V: H @. Q$ m2 e4 D作者：来自澳大利亚
( L4 }4 h( j4 Z6 i1 C0 l" D来源：Haematologica. 2011.8.9.: A0 P1 b: s4 \4 w
Dear Group," P* S+ V, M+ e2 q
& @5 ?- [+ a. I. rSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML2 M) `. J4 s6 |# c9 ]4 v% ?1 }' K
therapies. Here is a report from Australia on 3 patients who went off Sprycel7 o7 U# Q) g8 M$ R X4 }
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
4 _( A& Y ^4 f/ iremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
3 B# u* u! e- }% Z1 idoes spike up the immune system so I hope more reports come out on this issue.
% u2 x6 }5 u4 [
8 ~8 ~, ]8 Q8 o2 |6 NThe remarkable news about Sprycel cessation is that all 3 patients had failed3 d) [/ p/ r8 |( t
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
; ~- ?2 C) i) I: z+ f5 Hdifferent from the stopping Gleevec trial in France which only targets patients: z6 t9 u5 `: o/ d) u
who have done well on Gleevec.- J4 d/ E- Q5 a# `$ d- z
; [! V$ ~* o/ K8 G# i( n. z" o' u
Hopefully, the doctors will report on a larger study and long-term to see if the4 g e1 _& _' y( e4 G
response off Sprycel is sustained.+ n) j0 ?2 N2 h& U! O5 [
, X5 e# F! a) Y" g/ q
Best Wishes,. q- \- W3 Y0 z( v
Anjana/ B# r0 x+ X; D3 [2 S$ E
r* e( D9 h* f0 g1 [) Q
# D9 d- }, \; ]" H3 \- d* X0 n9 J; l' U) f. u& F% T
Haematologica. 2011 Aug 9. [Epub ahead of print]& K4 @/ h( f" S8 ]" g
Durable complete molecular remission of chronic myeloid leukemia following
O+ g" K2 {4 X& w3 W5 Ddasatinib cessation, despite adverse disease features.
: }1 m# G3 U5 l4 I/ HRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.% T) B4 ]+ D* i- ^) i7 E3 G
Source
" p6 j- P0 Y+ s, V C6 nAdelaide, Australia;) \6 G! s( I+ t- K, B4 P( V
' C1 A7 V+ v0 S
Abstract
; j% V$ h$ _4 C$ y: q( tPatients with chronic myeloid leukemia, treated with imatinib, who have a# m! u3 a% ~" f' j
durable complete molecular response might remain in CMR after stopping
- X$ n4 G$ i5 }3 m( E# [treatment. Previous reports of patients stopping treatment in complete molecular3 G) z5 {# w8 ?0 e8 H
response have included only patients with a good response to imatinib. We
2 X3 X: ?, \" ~% |) Bdescribe three patients with stable complete molecular response on dasatinib
* X6 _: e0 ^4 b8 Z; Ztreatment following imatinib failure. Two of the three patients remain in5 a% j* h& _- D4 r- }! t4 A1 O5 [
complete molecular response more than 12 months after stopping dasatinib. In# f7 {* c* x8 d1 L1 t4 R) o
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to# ^2 [ C1 @4 `% X# ? y: N! Y
show that the leukemic clone remains detectable, as we have previously shown in
/ X" R9 C, B R4 z/ dimatinib-treated patients. Dasatinib-associated immunological phenomena, such as" q1 {0 x- _! g1 N/ s9 t' [
the emergence of clonal T cell populations, were observed both in one patient# V: W O! m) X0 F
who relapsed and in one patient in remission. Our results suggest that the
: ?) j( e2 W1 g8 d1 Zcharacteristics of complete molecular response on dasatinib treatment may be% Y% |) e) _. @. k
similar to that achieved with imatinib, at least in patients with adverse( X B6 Q/ L3 P, J! _- s1 O2 y# z% X
disease features.
& x8 a( ]9 {; Q& p: i |
显身卡
