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。
" y4 I" \" U$ k) m1 v. ~ 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
0 K! u a( M+ s ]; x来源:Haematologica. 2011.8.9.
) H v' r. o! H$ q" ZDear Group,* z( U; Z, I- Y" W9 a9 J
8 c$ V( k: q3 I# b1 O& KSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
2 T% I9 v, {5 W& ?therapies. Here is a report from Australia on 3 patients who went off Sprycel8 t+ f5 E) D7 l3 ]! o6 G- |3 J" t
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients7 j. Q' r9 I) D
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
8 i% z+ N1 S" J5 g4 d( ^2 Edoes spike up the immune system so I hope more reports come out on this issue.& t& Q3 Q# P! D1 j. ^) t+ t0 l
3 l U% I) y1 m. A$ \The remarkable news about Sprycel cessation is that all 3 patients had failed
1 n0 q% `$ o1 l& ]Gleevec and Sprycel was their second TKI so they had resistant disease. This is0 J# R3 p. p, }) H
different from the stopping Gleevec trial in France which only targets patients. z+ g8 L6 b+ n* {' v/ ~
who have done well on Gleevec.) @0 e: ?- X, Q" ~* }
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Hopefully, the doctors will report on a larger study and long-term to see if the) x9 i) X) B$ C0 I
response off Sprycel is sustained.
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Best Wishes,+ U- s) \# W2 L n+ z& g
Anjana
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1 B, E2 Y G+ T! p- }; p) t6 FHaematologica. 2011 Aug 9. [Epub ahead of print]
G4 H6 @' F0 B R7 VDurable complete molecular remission of chronic myeloid leukemia following1 x3 P+ D; o3 L9 b
dasatinib cessation, despite adverse disease features.
3 e# I+ e$ s6 h: K% Y3 kRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.& \+ \3 v( _7 M
Source
; N3 o6 q7 k* \; gAdelaide, Australia;. g$ U8 B! P6 }/ G% q- H9 ?3 C
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Abstract
+ ?* H" Z+ s) K+ _Patients with chronic myeloid leukemia, treated with imatinib, who have a
8 J" g; S% J# hdurable complete molecular response might remain in CMR after stopping/ F- a( O8 y! J1 G8 r7 p( I% [) d
treatment. Previous reports of patients stopping treatment in complete molecular/ O9 [3 }+ E) t8 d9 i x# A) g" T
response have included only patients with a good response to imatinib. We
4 [# _3 l" ]8 i% Z1 cdescribe three patients with stable complete molecular response on dasatinib
. r9 U8 G8 Q* z; n0 Utreatment following imatinib failure. Two of the three patients remain in
% X4 O3 D7 v& d; m: ]: mcomplete molecular response more than 12 months after stopping dasatinib. In
% |0 i+ ^5 \4 S" Uthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to# ?# c! x9 I P/ c' W8 v- V
show that the leukemic clone remains detectable, as we have previously shown in/ v7 N0 E$ n$ `) h) V
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as) W5 L/ D- q& \) G8 D- x7 r# f$ G
the emergence of clonal T cell populations, were observed both in one patient) ]# j8 y/ ?% a9 D
who relapsed and in one patient in remission. Our results suggest that the
7 E% N. d/ m+ }3 Dcharacteristics of complete molecular response on dasatinib treatment may be8 C4 T9 w/ Y! O4 n, ]4 J8 t
similar to that achieved with imatinib, at least in patients with adverse
$ U$ U& C6 B% P3 ?! m' S% Gdisease features.
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