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。. f# v+ s2 J v: L9 y2 G& k3 T
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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" R# k2 q# t5 @0 _4 z) E作者:来自澳大利亚
' a+ R z, }: s; p来源:Haematologica. 2011.8.9.
/ A' v% X9 u6 @* E9 x# MDear Group,% ], U; I& j) P! L6 J* n, F
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
* V6 k% X( a. S6 ytherapies. Here is a report from Australia on 3 patients who went off Sprycel7 l9 J) I4 B) t' Y* H1 v' O( I
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients8 J# _5 H: }( l. `
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel- W# u/ [4 {. t& M
does spike up the immune system so I hope more reports come out on this issue.
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The remarkable news about Sprycel cessation is that all 3 patients had failed
2 M+ U5 R$ Q7 G" [& ~6 UGleevec and Sprycel was their second TKI so they had resistant disease. This is
$ w/ ~) \; {, }different from the stopping Gleevec trial in France which only targets patients
; ?6 G5 G3 m- `6 ]who have done well on Gleevec.
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6 F: O- C" K4 d0 j4 {Hopefully, the doctors will report on a larger study and long-term to see if the
2 [# i: f8 z0 h) O$ Aresponse off Sprycel is sustained.* c* y% E; u _, P! ]
1 [) `+ @: R: s3 BBest Wishes,, p9 L' A% G. F7 _
Anjana/ C6 {' B' t7 I B- j: Z( x9 g1 N
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Haematologica. 2011 Aug 9. [Epub ahead of print]$ r" K# {# ^6 q7 A
Durable complete molecular remission of chronic myeloid leukemia following' ^9 z% ]3 E# ]% }
dasatinib cessation, despite adverse disease features.
; [1 ]) |+ V. R$ N# gRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.# t* K$ T# m$ p
Source/ W, K$ j' t& S9 L/ ?. a
Adelaide, Australia;; R& r0 h; Z/ B* p7 `
% G' P% Q3 @" U: vAbstract
; [! P: W- }; u7 t0 JPatients with chronic myeloid leukemia, treated with imatinib, who have a
$ [8 t/ y1 Q0 ddurable complete molecular response might remain in CMR after stopping
# O$ }; T/ @% e8 s, ?5 Ctreatment. Previous reports of patients stopping treatment in complete molecular: e. x1 P9 s% W3 b+ u$ N6 T+ u
response have included only patients with a good response to imatinib. We8 ]* I" L! `! |! }( L% i5 [+ D
describe three patients with stable complete molecular response on dasatinib
! E- V3 @8 v+ A9 g8 T- f+ a/ ~2 L1 }" H1 itreatment following imatinib failure. Two of the three patients remain in# J* F9 m& C- s. c8 ^
complete molecular response more than 12 months after stopping dasatinib. In
" c: M5 }8 A( S+ [ ~3 ]" Ithese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
6 q( X8 m1 S8 \5 O( S( Pshow that the leukemic clone remains detectable, as we have previously shown in
# u. v( t! c, ~imatinib-treated patients. Dasatinib-associated immunological phenomena, such as! T- x( b+ g1 `& N) U
the emergence of clonal T cell populations, were observed both in one patient
' {' h3 f7 P" b: m! W# Awho relapsed and in one patient in remission. Our results suggest that the, z' U G2 I% S
characteristics of complete molecular response on dasatinib treatment may be+ [7 J. H4 L7 a4 p0 _% a
similar to that achieved with imatinib, at least in patients with adverse3 P2 T Z4 i; V R
disease features.
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