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。( D8 t, @( M( Q" G$ 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。6 y+ ^" V9 m" ]9 Y* r: B
. @- v; j# h4 x$ {* y作者:来自澳大利亚
! D; f; W4 }2 X1 p来源:Haematologica. 2011.8.9.
- b/ X; x. ]# L' r- X; G: hDear Group,) \- \( ?5 c1 L3 y
% h- c/ q5 r7 }# W' }7 ~, fSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
+ [0 g b* H F, a2 [/ D% Q& xtherapies. Here is a report from Australia on 3 patients who went off Sprycel
- D: D, H3 n2 w0 S9 O, Wafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
! U! p0 p9 E% S- Q ^remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel% o" U$ Y1 P6 x
does spike up the immune system so I hope more reports come out on this issue.+ }- T8 c1 N1 E F
- Y- ^% u* z$ p7 H' |2 LThe remarkable news about Sprycel cessation is that all 3 patients had failed; c% ?4 ~$ z2 }' \
Gleevec and Sprycel was their second TKI so they had resistant disease. This is7 ^: e! |$ N3 L) [- [2 d5 W
different from the stopping Gleevec trial in France which only targets patients' E; o- @# X$ k/ d
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 the
% X" l4 o0 O% N) O( Bresponse off Sprycel is sustained.
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! i; |) E& b( [4 \. p+ E. sBest Wishes,
7 u) i$ M. b6 q8 [" uAnjana
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Haematologica. 2011 Aug 9. [Epub ahead of print] q: X) _4 Z7 R& l2 ^( h
Durable complete molecular remission of chronic myeloid leukemia following" o; {$ J# c, i3 h8 G
dasatinib cessation, despite adverse disease features.! y. x5 H5 \6 l
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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Adelaide, Australia;
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4 c9 ~% p! H! r* U% L! ]+ S f& RAbstract
7 U, {6 b; C. L' ~) M1 tPatients with chronic myeloid leukemia, treated with imatinib, who have a$ e2 D$ M ?1 h5 h, D1 g% c
durable complete molecular response might remain in CMR after stopping
) s) @/ Q( i! t! }' Xtreatment. Previous reports of patients stopping treatment in complete molecular
& K( w$ ]8 B2 I) Y* A4 Y# Nresponse have included only patients with a good response to imatinib. We" f# ^4 l3 [! v0 Q' Q. c
describe three patients with stable complete molecular response on dasatinib
) y4 N v; s8 ?0 X9 dtreatment following imatinib failure. Two of the three patients remain in+ s) d" X* B2 `& B
complete molecular response more than 12 months after stopping dasatinib. In
9 B9 H8 Q0 O3 ?+ t1 I5 ]; U$ x9 Jthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
0 W* M8 B$ a8 g/ |show that the leukemic clone remains detectable, as we have previously shown in
5 w6 {) k6 n/ e; Fimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
* V( Z5 t& P% h1 P9 Ythe emergence of clonal T cell populations, were observed both in one patient
% j- }4 a6 E. C0 g H; M/ owho relapsed and in one patient in remission. Our results suggest that the
2 q* Z% D/ q) i- R" K# [characteristics of complete molecular response on dasatinib treatment may be0 C `8 k# z* A, ]1 S( @( _: S; \. D
similar to that achieved with imatinib, at least in patients with adverse
4 P8 n+ f# E( i! S! y3 I8 ~6 edisease features.
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