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。
) A% h B5 E, v$ F$ B, S7 p 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。( o2 ]# X# w4 D D! z- g. s) N* s
3 D/ ]# K- P4 p y- u( R作者:来自澳大利亚. a) I+ c( F; q3 e
来源:Haematologica. 2011.8.9.
. k* g/ o8 K: i0 F9 oDear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
! K6 s1 A, t6 [4 x0 Ktherapies. Here is a report from Australia on 3 patients who went off Sprycel5 ^% O, D; m; l4 _" N: x
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients3 s( S8 n/ y, i u% k
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
$ u2 x, U6 r# `8 edoes spike up the immune system so I hope more reports come out on this issue." B% ?% ?( l: E
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The remarkable news about Sprycel cessation is that all 3 patients had failed- a1 u, U1 m+ j) E9 E) |/ Q
Gleevec and Sprycel was their second TKI so they had resistant disease. This is8 z6 ?4 k& Z! n J0 e% f1 m
different from the stopping Gleevec trial in France which only targets patients) F6 i# u/ ]: ^$ N# P9 E0 Y1 |
who 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: [# L) |/ {& F% y# s
response off Sprycel is sustained.: F k# G/ X& w( J- G; I* U
! D! h$ w8 Q/ i2 r1 ZBest Wishes,
# a6 s. O3 p1 R j8 \* k( vAnjana
6 u1 R' u( J$ j1 ~$ K6 j: b9 I% Z% l5 y/ O+ b2 A% c$ A
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5 a' V6 N2 i+ JHaematologica. 2011 Aug 9. [Epub ahead of print]
2 G! p5 ~+ N5 u4 dDurable complete molecular remission of chronic myeloid leukemia following
+ e4 E! G$ | R' Q4 E. j; W# idasatinib cessation, despite adverse disease features.. } U7 g4 j; i2 ~$ R0 r$ O
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
, h. s5 ?$ h$ B* B% Q+ @9 KSource
) {, h( x, M* t& d1 F7 cAdelaide, Australia;2 I1 v* S* o& ^- Q& i
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Abstract+ v( r, }9 v4 y7 |" ?! H2 o
Patients with chronic myeloid leukemia, treated with imatinib, who have a
, ]* w( j1 G1 B9 s3 Bdurable complete molecular response might remain in CMR after stopping' o9 o" ~8 Y, m" b! ~3 Q; |* L- [
treatment. Previous reports of patients stopping treatment in complete molecular
0 ]* F4 `. y) L" D; Q1 i0 H# R# H' Cresponse have included only patients with a good response to imatinib. We4 p" @% l9 d& Z, @+ }
describe three patients with stable complete molecular response on dasatinib% U: c4 V4 q- b0 v3 l; s& ~
treatment following imatinib failure. Two of the three patients remain in" O( }! n4 h1 e- o& |0 M3 ?4 I
complete molecular response more than 12 months after stopping dasatinib. In+ n3 ^& }! m3 |6 d8 x* x# k
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
' p: U- Z; p& Wshow that the leukemic clone remains detectable, as we have previously shown in1 ]. \( I# D1 m! n& z% X0 s6 M
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as$ k+ a. b/ l# _; \
the emergence of clonal T cell populations, were observed both in one patient! s$ Y: G/ v3 K( A# @1 N b# x
who relapsed and in one patient in remission. Our results suggest that the
3 m& Z& A% V& r4 R+ Qcharacteristics of complete molecular response on dasatinib treatment may be
3 |2 T8 P4 M8 C( a, M8 T0 vsimilar to that achieved with imatinib, at least in patients with adverse8 {- S% E) G l
disease features./ v6 c7 M8 ~; e/ Q3 T; ?5 k2 y
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