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。, N9 M3 y$ x& W' c* J
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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! ]1 t7 }! ~% ?- l! k作者：来自澳大利亚, J- P) m8 X8 h: \5 p7 H. Z0 M
来源：Haematologica. 2011.8.9.
, K f0 J- z+ p" N! S3 e% A( b! VDear Group,
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# x N5 x5 y2 v& u) d- nSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
* i& H, b0 q, B5 Q# C; J4 H: Qtherapies. Here is a report from Australia on 3 patients who went off Sprycel3 F/ M9 A0 w' V6 T
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
) A3 F: G5 A# d& p; F6 M$ V Gremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
3 r" j) Y- I0 Q! i Hdoes spike up the immune system so I hope more reports come out on this issue.8 a) R3 d' z/ R4 f B z
. X, v2 \8 z7 t: _7 _ R0 h) x0 X% RThe remarkable news about Sprycel cessation is that all 3 patients had failed
$ |5 n. b/ q7 J1 _Gleevec and Sprycel was their second TKI so they had resistant disease. This is1 L3 x, H4 j: S3 B$ c
different from the stopping Gleevec trial in France which only targets patients
0 O# g2 |* v* M2 U) H+ @& Rwho have done well on Gleevec.
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7 H1 N& w* \+ g3 o7 d5 e. fHopefully, the doctors will report on a larger study and long-term to see if the7 E- \6 S$ C. {
response off Sprycel is sustained.
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Best Wishes,5 ]$ h+ N" F7 @6 a" T" p2 _/ m: W$ g
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]0 \3 L& F6 S3 g2 e& A( I
Durable complete molecular remission of chronic myeloid leukemia following
4 \7 {8 R$ a) sdasatinib cessation, despite adverse disease features.
. C) G) i6 Y6 p7 hRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP., }+ e5 T; m" \3 w# W
Source( U; j8 L# Q7 x d& l+ m! Z
Adelaide, Australia;7 d: H* F* M* [" Y! m. R: ^
8 A h" l" \4 M0 S; f$ eAbstract
1 p- h8 C+ r. h C6 b7 CPatients with chronic myeloid leukemia, treated with imatinib, who have a0 x# p" d* G) `; R0 s/ L2 n. q' A
durable complete molecular response might remain in CMR after stopping3 E7 T' o$ x u3 K1 x
treatment. Previous reports of patients stopping treatment in complete molecular
" d4 n$ N8 J$ \% n& O, o8 [response have included only patients with a good response to imatinib. We# w; s4 t+ j8 K) P9 ^! T+ t
describe three patients with stable complete molecular response on dasatinib4 K$ A7 P% c1 J% _5 v
treatment following imatinib failure. Two of the three patients remain in
# Q6 ^- @) q2 k( Y! scomplete molecular response more than 12 months after stopping dasatinib. In( Q& c% d2 u% G! h& z. b
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
7 M, `/ c) \& i6 L l( lshow that the leukemic clone remains detectable, as we have previously shown in
, \' e5 X2 k2 o& fimatinib-treated patients. Dasatinib-associated immunological phenomena, such as# u0 t3 q; b4 r H7 O E
the emergence of clonal T cell populations, were observed both in one patient/ u) D; n* q0 Z: v+ e6 H( K
who relapsed and in one patient in remission. Our results suggest that the! k' @( K: Q' z
characteristics of complete molecular response on dasatinib treatment may be
0 t- S" c! c. d% j% k, Asimilar to that achieved with imatinib, at least in patients with adverse1 J) J/ O! C. A0 x- O
disease features.% Z: H4 N- y2 X
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