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。
7 _8 S4 H Z# R; @5 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。2 k p' ^0 R8 m8 `) V& L! j( F6 {
; G# p: ]# K' c" y5 b% x% }" x作者：来自澳大利亚3 D# R0 L- t2 m* a7 o1 |
来源：Haematologica. 2011.8.9.& {! N2 d. G- p5 g' b
Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML+ k3 j7 O% `+ s1 R
therapies. Here is a report from Australia on 3 patients who went off Sprycel
7 u3 F3 z5 R% q5 O9 Lafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
' |$ m1 {- J( a3 D# v2 c, u: t. O \. oremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel0 N1 {' U; S" C% }7 L1 x* d) e
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
8 o- U) x, D3 r3 H. \, pGleevec and Sprycel was their second TKI so they had resistant disease. This is1 b2 u5 Z0 w: G& L& ?4 Y
different from the stopping Gleevec trial in France which only targets patients
7 B, x6 W6 ?% E: r5 z0 o# _who have done well on Gleevec.3 a8 s! W5 B9 @2 m4 z: `2 _0 B- p" g
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Hopefully, the doctors will report on a larger study and long-term to see if the/ Q4 A, K9 h6 J- k
response off Sprycel is sustained.
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Best Wishes,
+ b. z/ t; D) \% ]Anjana) }; _; k; T# b+ a# W
D. [2 ~$ K5 K1 o0 e3 T [
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Haematologica. 2011 Aug 9. [Epub ahead of print]0 a8 b& {4 a! Z0 \, X( U3 b
Durable complete molecular remission of chronic myeloid leukemia following
; Q) m& V) ^$ k1 a4 Y1 H M3 ydasatinib cessation, despite adverse disease features.
/ Z o) N. L. cRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP." y W, ~/ m5 R- b' K. A
Source3 N& U( _) }: z/ t4 |' E* _$ S
Adelaide, Australia;2 s$ _8 [7 }* ]8 O9 J- V3 n
9 ]; O8 d9 x* \+ j1 L
Abstract; F0 G% a) p0 ~3 @$ N! x
Patients with chronic myeloid leukemia, treated with imatinib, who have a$ M. i2 a8 M2 a. i$ k% V
durable complete molecular response might remain in CMR after stopping: l, y! F `0 f9 P& o5 C' s4 ]/ i
treatment. Previous reports of patients stopping treatment in complete molecular
o: C4 X$ [* q& b$ N. W, I Qresponse have included only patients with a good response to imatinib. We
. r, B7 {: k) qdescribe three patients with stable complete molecular response on dasatinib3 G3 o% {5 s4 h
treatment following imatinib failure. Two of the three patients remain in
5 A- }- c1 Q7 t0 @4 T5 z6 Ccomplete molecular response more than 12 months after stopping dasatinib. In
; F% M# A6 L( f. q! N' f% }) nthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
+ N) {9 |, f6 b" b2 ]3 xshow that the leukemic clone remains detectable, as we have previously shown in. R- x2 k, P8 }. j! X; [
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
% y: a0 z a# ythe emergence of clonal T cell populations, were observed both in one patient: _% i* e. C, n( k
who relapsed and in one patient in remission. Our results suggest that the; [, o9 ~6 L" s# j! B# ^- q
characteristics of complete molecular response on dasatinib treatment may be7 R0 v, y" r) h A9 j
similar to that achieved with imatinib, at least in patients with adverse8 n. F4 F* q0 c! d* O8 Q
disease features.
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显身卡
