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。
) O9 U6 ^ A! M/ \9 a: z a 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。6 O* f, d L: X" k1 ^; d1 @, o
1 C. ]/ Q& T9 x5 Z U; \3 x作者:来自澳大利亚
W# a6 n3 t$ P1 ^$ N来源:Haematologica. 2011.8.9., j: }+ K& F! @8 p/ m8 f; V
Dear Group,; G( [$ k7 r/ X$ `/ a2 ?
4 e5 ]" c1 J Q6 Z" p' w) r3 |# WSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML% C0 ]7 O* h; K
therapies. Here is a report from Australia on 3 patients who went off Sprycel( q- Q. o" q/ g1 M' [; u4 z* u* ^& d7 D
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients" j: ~! c( Y3 T Y* j
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel0 `. r' s( Z1 ~ L
does spike up the immune system so I hope more reports come out on this issue.) D5 I, y# a* q" ]6 I' Z" f+ P4 \
+ Y1 a* ^8 S" @$ ^; c: C8 \- \The remarkable news about Sprycel cessation is that all 3 patients had failed
( B, O8 }/ Z; B# G, R; VGleevec and Sprycel was their second TKI so they had resistant disease. This is& [8 t' O( Y2 Q8 T) h8 p: m
different from the stopping Gleevec trial in France which only targets patients1 M& X8 G8 y$ x
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 the
2 F1 G3 X' J* E& cresponse off Sprycel is sustained.' M4 J* z; c5 e
: F2 k) F, C# @. k8 qBest Wishes,
% b' x* j' ]% o9 fAnjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]% S( y9 B; o3 t2 L: C9 Y
Durable complete molecular remission of chronic myeloid leukemia following3 v( k* ]! }/ t$ ~3 J8 l) a
dasatinib cessation, despite adverse disease features.
2 h) A8 t& D5 z* z" G# _7 S& I2 v% J+ {Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.0 ^, @$ A. P' ?( i+ T& i
Source
1 V) v$ g% z0 P9 j% u: z4 c% AAdelaide, Australia;
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Abstract8 ?% O( E: u7 B' r t; \4 M, T& e
Patients with chronic myeloid leukemia, treated with imatinib, who have a
# q( ]0 A' `( j* T F: Mdurable complete molecular response might remain in CMR after stopping9 L/ Q( {$ q0 @0 c7 Q
treatment. Previous reports of patients stopping treatment in complete molecular. C- I" H/ l5 A* u
response have included only patients with a good response to imatinib. We: O. R# ?9 [# A5 Y3 I( v9 M0 e$ C$ h
describe three patients with stable complete molecular response on dasatinib
4 ~! i6 i' W; {. T) W. N1 b$ Qtreatment following imatinib failure. Two of the three patients remain in
) R. A" C" m2 I8 @complete molecular response more than 12 months after stopping dasatinib. In
8 A* M# O- A1 R4 r" L) S( U+ g5 ?these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
{5 y; A% _0 H$ U5 q; xshow that the leukemic clone remains detectable, as we have previously shown in! }8 R" z* J5 u& @3 c4 V! k8 W
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
9 q* v2 e6 P' f4 h! \0 B( bthe emergence of clonal T cell populations, were observed both in one patient
8 p* x1 k {7 I5 `who relapsed and in one patient in remission. Our results suggest that the
. M+ f$ N$ g }# Acharacteristics of complete molecular response on dasatinib treatment may be
/ `( c' J, c3 E8 A2 s2 ]& p4 ~. Psimilar to that achieved with imatinib, at least in patients with adverse: Z" _% Q! q9 z
disease features.
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