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。- Y: ?) F4 j3 p$ p( m
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。4 S, H. l$ D& a" c
' H0 y- `- _' \+ l7 P4 e作者：来自澳大利亚6 q i/ ]$ U& q( n
来源：Haematologica. 2011.8.9.8 a7 |5 [/ y; Q$ X4 [
Dear Group,$ h4 ~5 G3 V' x9 U1 l) r
: D: V0 s( m& v. Y& O+ t/ a1 w7 PSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
( B0 f( Z6 H' t; h& vtherapies. Here is a report from Australia on 3 patients who went off Sprycel1 o7 z, ^ m. ?1 ~/ c
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
2 b: G, K8 z. ]3 }/ b4 Dremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
9 j" H; j) k" Y" e% H- a& }6 }does spike up the immune system so I hope more reports come out on this issue." f( L2 P3 @5 c2 W! B
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The remarkable news about Sprycel cessation is that all 3 patients had failed
# \! H* x! X5 E5 b( iGleevec and Sprycel was their second TKI so they had resistant disease. This is
5 M" i# \: e/ O: Udifferent from the stopping Gleevec trial in France which only targets patients
. U' R" E: I- @" h7 C+ xwho have done well on Gleevec.; g1 O9 r+ ]$ r' a% _. W; g& X
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Hopefully, the doctors will report on a larger study and long-term to see if the J3 |' o4 Q7 o1 L' K$ D4 C
response off Sprycel is sustained.
S7 L+ }* r, }7 `8 a% b' Z; ^6 P# j3 |/ t8 V
Best Wishes,/ ]6 _" d" l8 s, i! T. u. e; b
Anjana+ ~& O( j X' ?! Z5 ?* s
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Haematologica. 2011 Aug 9. [Epub ahead of print]9 s `$ G* Z9 o( {
Durable complete molecular remission of chronic myeloid leukemia following
9 E' X$ A6 z6 k& p% R* x7 Tdasatinib cessation, despite adverse disease features.! W. F2 m0 D" Z% E
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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Adelaide, Australia;/ h0 z& J/ i( Q# _* B( B
" Q I, T! A- ^3 [* |) F% b4 B
Abstract
# r$ L8 S; Q! j9 n# ~' y4 A0 aPatients with chronic myeloid leukemia, treated with imatinib, who have a+ t* p) o) ~ O% f2 [( C+ a
durable complete molecular response might remain in CMR after stopping
8 i% _* l7 Q$ Z/ y Xtreatment. Previous reports of patients stopping treatment in complete molecular8 Y8 ~1 \. y# W) t8 s
response have included only patients with a good response to imatinib. We
" O7 D% h8 i* d' y% q+ p) `describe three patients with stable complete molecular response on dasatinib
( y/ `+ L* X& C& t4 Etreatment following imatinib failure. Two of the three patients remain in: |0 l" k N/ B5 q
complete molecular response more than 12 months after stopping dasatinib. In' S0 n1 ~( l1 I, Y
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
' x& _8 f: w( p4 Z1 I' Nshow that the leukemic clone remains detectable, as we have previously shown in/ |) y- Y. d, M0 L3 k! {
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
9 I1 O: F4 f/ w8 D( g! C5 m# `the emergence of clonal T cell populations, were observed both in one patient. i( t; Y+ {+ L) J" L, v
who relapsed and in one patient in remission. Our results suggest that the
) Z$ @: O& g# R3 X% X- R$ o2 [' M- Rcharacteristics of complete molecular response on dasatinib treatment may be
4 m: o6 n+ j: ^: Z( Csimilar to that achieved with imatinib, at least in patients with adverse; N. r5 X4 n4 V8 b) R. Y
disease features.
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显身卡
