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。# {) l# w5 _! b! @0 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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: f* G; l% T0 c; g8 j作者：来自澳大利亚) n5 y' Q! H* A1 J$ U L7 x
来源：Haematologica. 2011.8.9.1 z; \! V O3 O) Y8 c5 M1 E; E$ j: @
Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
0 h+ X7 M7 b5 v+ f; otherapies. Here is a report from Australia on 3 patients who went off Sprycel( [- J1 c- g1 j% [4 X
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients3 }9 l8 h6 i$ R% C$ H/ i: o+ @
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel+ L* |; L7 p6 p$ C5 m1 v
does spike up the immune system so I hope more reports come out on this issue.
& P9 D' M! X% _( e9 K8 O4 d3 B$ q# Q/ w" ]! Q
The remarkable news about Sprycel cessation is that all 3 patients had failed5 C7 G. c! x7 K- F# n( X
Gleevec and Sprycel was their second TKI so they had resistant disease. This is, s1 a/ S1 V1 g. L8 ?% H8 K5 W
different from the stopping Gleevec trial in France which only targets patients
. Y& @! n7 _9 Z$ i+ h6 nwho have done well on Gleevec.6 Q, [( f, i7 M* b5 O/ c2 z$ r
8 D* h& G$ |! d9 KHopefully, the doctors will report on a larger study and long-term to see if the. S" K/ H( ^5 n, ~
response off Sprycel is sustained.
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Best Wishes,
2 W; Z+ R u' I0 DAnjana& g9 g- O+ x) K0 x' g# M. o/ h6 f% q
% v2 a! m+ P' o( k' n: Q. F
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/ Q7 f, k5 L4 f; EHaematologica. 2011 Aug 9. [Epub ahead of print]
; @6 R1 e9 I8 K$ \, O' WDurable complete molecular remission of chronic myeloid leukemia following
. O1 o9 i& @5 c( \dasatinib cessation, despite adverse disease features.
3 F- j. z- I/ t- A4 U4 q7 ~Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.7 s/ |4 w9 E, t$ h
Source! ?+ B" a0 _) j/ E: {
Adelaide, Australia;# X* X6 K) z. Q' f1 b5 t
, d# C7 p+ y+ @2 \; F& E; eAbstract
% O: Q7 |& d. n: t5 }Patients with chronic myeloid leukemia, treated with imatinib, who have a
% }, `1 u" u6 L% Idurable complete molecular response might remain in CMR after stopping
" l m5 W7 J, f/ ? btreatment. Previous reports of patients stopping treatment in complete molecular
3 J u* n5 @7 P Z$ xresponse have included only patients with a good response to imatinib. We" y$ @9 D& G' D% `% g7 L* Z! U
describe three patients with stable complete molecular response on dasatinib& n3 ^. ^8 V6 X; s
treatment following imatinib failure. Two of the three patients remain in
7 n! ~2 W1 G/ X7 {* hcomplete molecular response more than 12 months after stopping dasatinib. In! h+ S5 W7 I2 s8 i( v7 h5 R
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
0 H( O- ]/ Z: e# r }/ j/ Rshow that the leukemic clone remains detectable, as we have previously shown in) r+ |: {! Z* [: @, i
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
1 q7 _8 S* O+ kthe emergence of clonal T cell populations, were observed both in one patient
$ l; c% F2 r8 ^2 T/ cwho relapsed and in one patient in remission. Our results suggest that the
; A6 x: J) q. m: Scharacteristics of complete molecular response on dasatinib treatment may be! x( ]6 u) _/ G$ v7 v
similar to that achieved with imatinib, at least in patients with adverse
/ c$ q6 \( U8 D2 z" Y0 M, ]6 Idisease features.0 G# ^5 i. Y7 k1 a1 l
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