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。
) ] U. z0 Y. h. s/ N2 S( E4 t$ Q 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。( W: j) L) T7 G+ v
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作者：来自澳大利亚& z& W4 t: Z1 F$ E. u. O: g
来源：Haematologica. 2011.8.9.
6 n# f* ?" M5 u" G/ `7 XDear Group,
8 W: o7 Y) [$ H: V: p$ F: f3 V+ [. o+ g2 k
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML- s g: p8 _- f5 T2 ^- d5 E
therapies. Here is a report from Australia on 3 patients who went off Sprycel7 |; I z+ `! C0 T3 s
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients9 ^3 A5 R; l- A/ S3 \- y1 x) Y
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
, X. s& N3 J8 e& q: y2 ndoes spike up the immune system so I hope more reports come out on this issue. D1 D, U3 k4 `- |; F H+ p
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The remarkable news about Sprycel cessation is that all 3 patients had failed1 o% g8 @* \, ?- W" {2 A
Gleevec and Sprycel was their second TKI so they had resistant disease. This is, ?; X1 D N9 T1 ], }7 } i. J
different from the stopping Gleevec trial in France which only targets patients
3 E9 L% G p v# gwho 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
" m8 G. Z1 C" p. l( ^+ T- Cresponse off Sprycel is sustained.
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Best Wishes,
/ i9 [! R1 ~7 N% QAnjana) x* M" @4 t& Y1 t
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Haematologica. 2011 Aug 9. [Epub ahead of print]# U- n) u6 f8 n- K- p. X
Durable complete molecular remission of chronic myeloid leukemia following- a/ E1 W8 Z4 L1 D' e% D$ p: D: M
dasatinib cessation, despite adverse disease features.6 K8 B6 a7 n- X5 L
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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Adelaide, Australia;
$ C/ c8 O. e& M, B3 Q( d3 Z2 ^( ]- P; `+ g8 Q
Abstract+ ? H/ G5 W; I
Patients with chronic myeloid leukemia, treated with imatinib, who have a2 t, _, {+ p4 j6 x) [
durable complete molecular response might remain in CMR after stopping
. G$ r& _- \; Ltreatment. Previous reports of patients stopping treatment in complete molecular
; \$ J0 _$ e. `. {8 S7 i( | Cresponse have included only patients with a good response to imatinib. We$ x4 \8 ?' Q# C' ^* O, B) Q. {; E
describe three patients with stable complete molecular response on dasatinib
; c/ y+ |' T4 n0 Ytreatment following imatinib failure. Two of the three patients remain in, N( d" q4 y) Q( E
complete molecular response more than 12 months after stopping dasatinib. In
) m8 j, y, I0 v: [these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
( B r1 z( m' C/ C* D A) o' lshow that the leukemic clone remains detectable, as we have previously shown in8 t& ~2 l* t/ _) k/ _* _) e
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
& \5 Q2 {2 H) U" H7 ithe emergence of clonal T cell populations, were observed both in one patient
' R: _, F" X# m5 A& swho relapsed and in one patient in remission. Our results suggest that the; P. h0 z; [5 o z3 V
characteristics of complete molecular response on dasatinib treatment may be4 U8 e1 {3 @1 Z' e& |" I
similar to that achieved with imatinib, at least in patients with adverse" {! g: W6 _' S+ @5 ~3 m
disease features.+ a2 G3 `- S: s, l+ f; {1 B- ?
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