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。
0 x6 Y6 x. p7 [8 a R& E3 m 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 J, K& R, \4 w. x! }$ b
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作者：来自澳大利亚- P6 r( l- h G/ i5 [( p
来源：Haematologica. 2011.8.9./ ^' a' X' f/ f5 d2 I u
Dear Group,: M y( N5 `2 L+ X* t9 @9 M
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML0 Z0 [3 o% i3 h, a$ \3 T, ?7 L8 N0 Y
therapies. Here is a report from Australia on 3 patients who went off Sprycel! q, r6 o, @8 R/ D
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
* w8 W, I, e% U$ i- {. c8 T- aremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel* ~; C w0 ^# {. q# |" S B2 W
does spike up the immune system so I hope more reports come out on this issue.$ m! s4 Y4 M6 G7 X
# c. p: v5 l! b) i. k) ZThe remarkable news about Sprycel cessation is that all 3 patients had failed
( O& k' O% H6 @! eGleevec and Sprycel was their second TKI so they had resistant disease. This is
0 x3 Q2 T& p! N/ \* W9 v+ N! edifferent from the stopping Gleevec trial in France which only targets patients" W( l# c( Y* e
who have done well on Gleevec.
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9 f! P( D2 a6 z3 x' g3 sHopefully, the doctors will report on a larger study and long-term to see if the
, e+ z; }) U. O* V1 ~response off Sprycel is sustained.
. `* I- |, J' o+ x5 |& w8 @% Q% Z6 y4 y! ~3 z8 x" g
Best Wishes,4 h( S a0 y5 k7 j8 h
Anjana
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( H! } z. @" BHaematologica. 2011 Aug 9. [Epub ahead of print]1 \) v* W. s0 b5 }
Durable complete molecular remission of chronic myeloid leukemia following, r. |: {! Q9 N
dasatinib cessation, despite adverse disease features.6 ~1 i: ~: i2 H/ G% o
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.; q0 q% K4 e$ u: m* h
Source
% Q* V- Y; q0 _2 ^$ L# A5 ?Adelaide, Australia;
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& P- e$ e. N% V% k8 O9 QAbstract
% }0 _: S) b, APatients with chronic myeloid leukemia, treated with imatinib, who have a
3 V( N2 Q3 M9 i* H. w2 k; Rdurable complete molecular response might remain in CMR after stopping
/ @& w6 n' ?4 Q c7 Y, @4 vtreatment. Previous reports of patients stopping treatment in complete molecular7 i& x6 c7 D0 X
response have included only patients with a good response to imatinib. We0 |8 ]2 D, k# j. y/ }: W7 H
describe three patients with stable complete molecular response on dasatinib
( H" b# ^" f6 `/ W6 G9 n: Q; mtreatment following imatinib failure. Two of the three patients remain in
+ N# F7 a9 R. V Z) \/ Ecomplete molecular response more than 12 months after stopping dasatinib. In- [% \% g! Z4 N G
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
( M! Z# i. Y- Ashow that the leukemic clone remains detectable, as we have previously shown in: v6 |6 A* i! @; g5 w6 e
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as# E6 f$ ^7 D* {, U, b$ b: \! v
the emergence of clonal T cell populations, were observed both in one patient
7 b. _) h3 c8 x" Mwho relapsed and in one patient in remission. Our results suggest that the' I+ e: n8 H2 w* @
characteristics of complete molecular response on dasatinib treatment may be
1 V7 x. v, H- L6 ksimilar to that achieved with imatinib, at least in patients with adverse
& v/ A3 O7 W: Vdisease features.
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显身卡
