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。
- w0 L9 G D3 C) t2 K4 L 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。$ Z5 c3 q% P9 v1 @1 c
2 W% p, y6 M/ g( o5 I作者:来自澳大利亚
( C) B/ j+ w9 Z4 d i来源:Haematologica. 2011.8.9.4 C2 |& Z* }% N9 m
Dear Group,0 W+ t7 H% k& W t9 e
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML( Q- p9 `) T. n
therapies. Here is a report from Australia on 3 patients who went off Sprycel, u# L4 H$ e* B. V. K# O
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients* G% I: q$ \- C# c+ {+ z) D6 t
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
& P {' V: q+ k% Gdoes spike up the immune system so I hope more reports come out on this issue.
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/ ]# v- v6 a. b8 Q' O5 x; gThe remarkable news about Sprycel cessation is that all 3 patients had failed2 o* \2 G" |2 C: N
Gleevec and Sprycel was their second TKI so they had resistant disease. This is4 k& T5 u+ L% _# v" { O. T
different from the stopping Gleevec trial in France which only targets patients' Z/ c9 s- o. ~1 v9 g
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 the6 M$ H% N O# I: d
response off Sprycel is sustained.3 F! P3 B5 _$ D8 U" q
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Best Wishes,0 }3 ^" Z/ o! b, j" e
Anjana
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3 f% z3 m: } y+ [* X( pHaematologica. 2011 Aug 9. [Epub ahead of print]" D. @, I Y2 e$ j9 b
Durable complete molecular remission of chronic myeloid leukemia following9 w4 e/ b- A. z9 T/ h( j
dasatinib cessation, despite adverse disease features.
/ B) @% [! A3 O* @$ v/ a- ]Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
, L; Z7 G( O6 d. N; @8 aSource, E" U; u4 V! `. v$ T h
Adelaide, Australia;
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Abstract2 t+ y3 C# X! h+ f
Patients with chronic myeloid leukemia, treated with imatinib, who have a3 T' U3 s$ [% l+ t1 b& s$ d
durable complete molecular response might remain in CMR after stopping
; {: }* j% }6 K- otreatment. Previous reports of patients stopping treatment in complete molecular
& ] L" `) r0 ^, I" x8 p" Oresponse have included only patients with a good response to imatinib. We$ g3 y9 z$ I% E8 h) X+ H7 ]
describe three patients with stable complete molecular response on dasatinib
- C$ p9 V# ~* y: W% w+ Vtreatment following imatinib failure. Two of the three patients remain in
. n# {7 N" X8 z( B$ D/ Zcomplete molecular response more than 12 months after stopping dasatinib. In# K) t" M" {5 n$ y$ }4 i
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
$ \% K. v' N4 T& \show that the leukemic clone remains detectable, as we have previously shown in
9 t) {" i$ M( [) S+ q8 h3 gimatinib-treated patients. Dasatinib-associated immunological phenomena, such as% P+ {. W# A7 e9 c; M. U
the emergence of clonal T cell populations, were observed both in one patient( ^! ]4 }8 z- g; |$ u7 X9 R
who relapsed and in one patient in remission. Our results suggest that the
+ X4 }, f- {8 |) @characteristics of complete molecular response on dasatinib treatment may be/ {) @& V) O* {/ S- `3 e0 c" H
similar to that achieved with imatinib, at least in patients with adverse4 O) s1 M8 ` I7 I) ~- G4 X( j: \
disease features.
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