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。; p! g1 Z0 M7 ^( l1 w
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。" i/ W7 w1 b0 L* k
7 Z! T) ~1 f5 d) O3 o作者:来自澳大利亚
) K; H- a3 e. _1 X3 _来源:Haematologica. 2011.8.9.2 w4 \' K0 ]- O* b- \
Dear Group,) u3 G; d- p, m+ u0 ~2 V5 O
9 d1 g, |; A2 G& w1 n8 X- nSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
3 \: z/ Y3 _8 s/ V& K0 t2 ctherapies. Here is a report from Australia on 3 patients who went off Sprycel
% ]. U! F1 O0 ?0 o4 b; _' \# eafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients+ j# L7 m+ F' S
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel7 G. ]( ~2 t8 W9 Z2 L: `) y! f O
does spike up the immune system so I hope more reports come out on this issue.
) F) K+ Y0 w W4 E$ i7 B7 r
$ t& v6 `- ]2 X/ X) e$ d- NThe remarkable news about Sprycel cessation is that all 3 patients had failed
+ d, B; W& a+ F( a, E+ g$ m1 ~Gleevec and Sprycel was their second TKI so they had resistant disease. This is
/ K, }1 m1 v/ Ddifferent from the stopping Gleevec trial in France which only targets patients
! b0 w a# ~+ `9 A h S. [who have done well on Gleevec.# M$ `: l) F$ Y; ?4 R5 k7 R
5 S1 ?2 i. K4 i3 \* C$ l8 e+ tHopefully, the doctors will report on a larger study and long-term to see if the
4 T3 Z) T2 r7 I6 [% @4 N9 t+ R; cresponse off Sprycel is sustained.4 \4 a6 c; W& @: e9 p# K( V
; ]; ] ~9 r2 u5 F2 a" m
Best Wishes,8 Y# T M! d8 _! z
Anjana* P* b; s* q4 {
. e$ `( t% a: i: K0 e; r
9 A: S9 e- u1 ^. a
. g6 l+ I) m+ j- iHaematologica. 2011 Aug 9. [Epub ahead of print]0 ^( V9 Y+ L0 T
Durable complete molecular remission of chronic myeloid leukemia following* u$ u% c; U$ f
dasatinib cessation, despite adverse disease features.5 O7 t" d7 Z5 w' s
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
l/ B/ i* J( U+ o% uSource$ ?' H$ a0 u) [- y8 Z
Adelaide, Australia;+ e8 m3 d$ ~1 }5 X8 c3 g p/ l
5 G6 ~( W) G6 l0 u( d$ U9 @1 pAbstract
) l# _/ t- [. } G5 N; x. yPatients with chronic myeloid leukemia, treated with imatinib, who have a. s- m( S" a8 K3 E
durable complete molecular response might remain in CMR after stopping
- N2 X# O# Q8 n; Streatment. Previous reports of patients stopping treatment in complete molecular
1 z0 H# r! w% t$ fresponse have included only patients with a good response to imatinib. We9 v5 c+ I7 K6 g" D- m/ U
describe three patients with stable complete molecular response on dasatinib" z6 y' ~0 o1 I" i0 Y
treatment following imatinib failure. Two of the three patients remain in; G& ]5 t! W# U5 k# l2 L4 S" `
complete molecular response more than 12 months after stopping dasatinib. In
* W, B) l, A+ K& e$ [5 [these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
3 I7 N: ~9 P: r4 C9 D0 `% ?show that the leukemic clone remains detectable, as we have previously shown in
# x8 y; a9 k8 ~imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
& p. B/ }2 h% X3 K" m& R# `9 I; Pthe emergence of clonal T cell populations, were observed both in one patient
! E* m- Z, P; h* ?who relapsed and in one patient in remission. Our results suggest that the8 X, M# ]8 A4 A
characteristics of complete molecular response on dasatinib treatment may be1 Y F: J" `& R4 u$ i1 t
similar to that achieved with imatinib, at least in patients with adverse$ `' i4 B) q+ v7 L& d d
disease features.' F5 M+ ?; m" P; k2 W
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