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。
* x( O1 F" U) D# b; J. N 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。
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作者:来自澳大利亚% U" `8 S& R$ \; I& X% r
来源:Haematologica. 2011.8.9.0 h+ m+ R4 \2 L7 k4 l" c
Dear Group," Q; f. D% _. r& |
' F4 I' K$ ~: I0 s6 ^# Y2 hSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML8 l9 w: C& c) i" c, `' r
therapies. Here is a report from Australia on 3 patients who went off Sprycel
+ [2 w; S7 P v" O. R' rafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
+ R3 _+ o E: f, l3 V5 D; V# Uremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
; E7 t v7 F8 A$ Udoes spike up the immune system so I hope more reports come out on this issue.
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3 y: O' ]) Y5 O b GThe remarkable news about Sprycel cessation is that all 3 patients had failed
' P3 |7 E% {( P" sGleevec and Sprycel was their second TKI so they had resistant disease. This is. U* Y4 ~6 j9 h
different from the stopping Gleevec trial in France which only targets patients
0 m# [9 N1 W+ V3 O. }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 the6 d+ h8 l# i! R" d
response off Sprycel is sustained.2 Q) @1 O' }7 e, Q# y5 ]6 \
& ]7 a2 d9 ]! \- f1 dBest Wishes,( u6 k4 E8 X# K0 x
Anjana
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( m, a o, o6 b" RHaematologica. 2011 Aug 9. [Epub ahead of print]
" E9 B; x( D1 I. P- S0 BDurable complete molecular remission of chronic myeloid leukemia following" C" Z2 d( U% y+ u. |2 {/ S$ V1 y
dasatinib cessation, despite adverse disease features.# j W- X, \! J1 y" P) q2 C
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.# w' k2 a. W8 V: l/ `
Source% h4 V0 A# d# c" |* {. @: y$ q
Adelaide, Australia;) d- h0 u" m& }7 A. K
2 [6 D' H8 ~: r: Z# ~& O' q0 zAbstract
o, e. V. M5 i0 a4 e3 g; }5 mPatients with chronic myeloid leukemia, treated with imatinib, who have a) j: _" {: g! V" V! Z2 f9 c8 [. g
durable complete molecular response might remain in CMR after stopping
! D8 l& g, o5 v k8 p7 G5 X8 gtreatment. Previous reports of patients stopping treatment in complete molecular+ H( d3 t% n- [! }* ^
response have included only patients with a good response to imatinib. We# G7 Q; z7 `- V1 ?& F9 ?
describe three patients with stable complete molecular response on dasatinib
0 E4 q' M8 ]- z/ a7 Xtreatment following imatinib failure. Two of the three patients remain in5 k" U. f6 q. D2 H. P, a
complete molecular response more than 12 months after stopping dasatinib. In+ I# D) T! Y# c! W* ^' p: ]& F
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to: ?3 Y E! b$ b2 Y- F4 E+ P
show that the leukemic clone remains detectable, as we have previously shown in
7 g/ q) s' b1 z& R& gimatinib-treated patients. Dasatinib-associated immunological phenomena, such as! s8 z# T. K3 n1 [8 x
the emergence of clonal T cell populations, were observed both in one patient/ g6 Z1 F" `2 b: Q; ^6 E5 A
who relapsed and in one patient in remission. Our results suggest that the! x; C7 V" e Z. ]9 J, v) O
characteristics of complete molecular response on dasatinib treatment may be
, k6 S- m3 L, {- V r8 Esimilar to that achieved with imatinib, at least in patients with adverse
, i0 _7 t* K4 ydisease features.
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