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。
    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。

( U8 q( ]+ w! E  h作者：来自澳大利亚
8 a5 Z/ X- g% W7 T+ B来源：Haematologica. 2011.8.9.
6 d5 k5 h+ Y+ }3 W% E$ cDear Group,

Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
9 |. E% O+ I2 c5 N0 dtherapies. Here is a report from Australia on 3 patients who went off Sprycel
* n1 O* g* I+ S! _( Vafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
) y% b8 X( M1 {does spike up the immune system so I hope more reports come out on this issue.

) S  L% o9 h2 Q. ?) bThe remarkable news about Sprycel cessation is that all 3 patients had failed
- E* D9 a4 z! _% T% xGleevec and Sprycel was their second TKI so they had resistant disease. This is
4 I# u! z, V# V  ~2 Ddifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
( C: E$ c, q( ~, w. T% d. ~1 P
Hopefully, the doctors will report on a larger study and long-term to see if the
  J3 p8 \8 z  H/ h1 D$ b) r1 Oresponse off Sprycel is sustained.

Best Wishes,
4 l5 `% S4 d; L9 ^Anjana
/ ]) C7 ?% k: S0 k- F9 `- v* x: U* @3 @
! k% u( e7 i& s  A& q, d
1 ^2 b; ^4 h' I: \3 `1 G
Haematologica. 2011 Aug 9. [Epub ahead of print]
  V$ F* l; D* b7 d  fDurable 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.
3 V6 p% T# ?& V6 ESource
: n1 T8 J7 ~: l7 [Adelaide, Australia;
8 ?4 `" ^. \7 u7 k7 R4 b9 ~. U1 {
Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
' ?; s! b# z/ |5 s- ~7 udurable complete molecular response might remain in CMR after stopping
" A: T8 i; A. T( @1 n% dtreatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
, m, J& o! y: R+ ?describe three patients with stable complete molecular response on dasatinib
: k  \3 d& K! Etreatment following imatinib failure. Two of the three patients remain in
1 K9 s" P+ i; P! R* C1 jcomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
+ q9 k4 e% f+ lshow that the leukemic clone remains detectable, as we have previously shown in
0 s6 R' `8 l2 Y: p1 R9 a( y( Wimatinib-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
9 A+ h/ z( D2 S  D# p3 r8 ?- Acharacteristics of complete molecular response on dasatinib treatment may be
% B9 p4 I1 K& ^' p. a, zsimilar to that achieved with imatinib, at least in patients with adverse
disease features.
2 ]- {1 c0 r; V% `% ^* X) P

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。

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