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 ?0 @' R3 Z6 C# f$ p 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 h# M F6 I& y" I! a2 a
8 p+ O3 j! t: f: |/ F4 N作者：来自澳大利亚0 V$ o4 B7 u; R: @; [) @
来源：Haematologica. 2011.8.9." W! a) w2 V; y3 R
Dear Group,' z9 K s6 g) w. \1 _0 @+ J
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
1 y' e4 R$ b" I9 m$ _% ^therapies. Here is a report from Australia on 3 patients who went off Sprycel9 Z5 F+ W# P% ~& v2 Q
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients* W! u4 o, h; Q3 T/ L* k' w
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel' J/ }) C1 t2 `% K- W! N' E
does spike up the immune system so I hope more reports come out on this issue.- J2 r$ X: q' v* K$ I; i8 |7 U1 {
0 G0 K6 s. @% ?: i: r
The remarkable news about Sprycel cessation is that all 3 patients had failed
; a/ ?0 i" U7 l9 q) gGleevec and Sprycel was their second TKI so they had resistant disease. This is
1 a/ C% g8 R$ sdifferent from the stopping Gleevec trial in France which only targets patients
{! N, t% ?- d5 S9 z, }+ c: ]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 ]5 H" H( R5 C# Q& h
response off Sprycel is sustained.
C: ~8 B& T/ F3 d( l6 Q! E! Q9 |1 ?3 o. u
Best Wishes,
s, Z/ {2 ?) _+ ?! ZAnjana* y( _: r8 N. `5 v! X* {# D
! T6 b" [& j5 a7 ?! T/ R% ]5 S- b% } L- p! D! P+ P; t, N1 X; w
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Haematologica. 2011 Aug 9. [Epub ahead of print]
% Z5 W1 ?5 R+ f, X% m$ BDurable complete molecular remission of chronic myeloid leukemia following! C* D( `/ W. P' j
dasatinib cessation, despite adverse disease features.
X/ }2 {9 S4 }6 e% `" }Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.4 ?" |/ W1 C$ S; I$ q3 y
Source
4 |$ W0 Y! C3 L6 L: N# J9 hAdelaide, Australia;# x+ b6 U8 b( I4 c$ c7 V. b) u
' w2 \8 ~% }3 R4 m
Abstract
: v. F! z& R) |, a5 O. m3 LPatients with chronic myeloid leukemia, treated with imatinib, who have a
4 d/ z8 y( M7 z6 g0 m3 zdurable complete molecular response might remain in CMR after stopping
* c' j3 T0 L+ b" |$ P5 L. l6 H& B: ]treatment. Previous reports of patients stopping treatment in complete molecular
* _( Z) w/ a! V5 `/ `- vresponse have included only patients with a good response to imatinib. We. X; c5 J; c% M( J: h
describe three patients with stable complete molecular response on dasatinib3 X% G7 k2 l4 V; s% s9 E3 ?
treatment following imatinib failure. Two of the three patients remain in' |) Z! s9 d% ]) X( }
complete molecular response more than 12 months after stopping dasatinib. In
& K+ o9 ~9 U8 S; {4 z& P& `' `0 ^these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
4 C8 q/ C P# Fshow that the leukemic clone remains detectable, as we have previously shown in; @! d/ [; C$ L3 R# C+ z
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as, ^3 R9 ]1 h: ^
the emergence of clonal T cell populations, were observed both in one patient
9 M4 y1 g0 w) \8 n' ]- zwho relapsed and in one patient in remission. Our results suggest that the, Y* n5 V( c2 i
characteristics of complete molecular response on dasatinib treatment may be
6 m4 o9 G6 l! Z8 m0 z% z9 }7 y" Ysimilar to that achieved with imatinib, at least in patients with adverse
% {2 x3 t. G1 t3 Z2 Odisease features.
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