关于停药的相关内容

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。
    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 p" t8 M( \; I1 k- a- z作者：来自澳大利亚
) `) `7 i) T$ u来源：Haematologica. 2011.8.9.
Dear Group,
9 p. c; j! c2 u% D9 W" r  C
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. Here is a report from Australia on 3 patients who went off Sprycel
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
; f) S* n. H8 }3 [# L1 m7 adoes spike up the immune system so I hope more reports come out on this issue.

The remarkable news about Sprycel cessation is that all 3 patients had failed
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
" ?3 S( Y1 y0 k: {) w9 H2 R& Y( P( _! Hdifferent from the stopping Gleevec trial in France which only targets patients
1 h) Z, g) {! ewho have done well on Gleevec.
6 a# `7 k3 f' n7 Y9 V0 w( g
! S5 h6 B# S2 C; }Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

0 ]+ R' W( e+ |# v. mBest Wishes,
2 j, X# }3 J2 P' e/ j0 T, |( RAnjana

8 Z( m5 f- {9 s8 j+ J
# w, Q0 J7 R/ z7 D9 `
- d) o1 p- Q2 D: VHaematologica. 2011 Aug 9. [Epub ahead of print]
) i' M8 k2 k  R. Y' tDurable complete molecular remission of chronic myeloid leukemia following
  ]8 |4 ~5 Q& o; ]" @dasatinib cessation, despite adverse disease features.
$ U+ C4 y" F7 Y- v, MRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
Adelaide, Australia;
0 z8 Y! e( y5 t9 L# H
* ]" J* x1 o/ @: i- [* @Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
3 y, h# V! L3 u; z9 j' Mdurable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
3 n; A' p% `2 u# vresponse have included only patients with a good response to imatinib. We
, Q; ]% g' [: v8 _: Fdescribe three patients with stable complete molecular response on dasatinib
2 }+ V0 x3 n4 n9 h0 U) U# Streatment following imatinib failure. Two of the three patients remain in
8 o1 L  ?6 G  P# _, a9 ncomplete molecular response more than 12 months after stopping dasatinib. In
  z0 W5 q6 g8 h- w* B$ Y$ {$ n% Cthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
" f; Q! _/ L, w8 [( d9 ~# @0 w# Qshow that the leukemic clone remains detectable, as we have previously shown in
# A' c) ~" S/ V6 d7 C  }imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
who relapsed and in one patient in remission. Our results suggest that the
+ c1 {( A$ G, ^5 i( ?characteristics of complete molecular response on dasatinib treatment may be
8 d- U% h6 |$ M1 W! x' K4 Usimilar to that achieved with imatinib, at least in patients with adverse
- d/ P. v0 E, Adisease features.

摘要：（STIM试验为法国的格列卫停药试验。）这个研究中，患者先是取得了CMR（融合基因转阴），然后停用格列卫，而后复发。15名复发患者在重新服药后又一次取得了CMR，他们同意再次停药。
    第一次CMR持续时间为31个月，然后患者停药，复发的中位时间为2.6个月，然后重新服用格列卫，中位时间5.3个月之后取得第二次CMR。保持第二次CMR中位时间19个月之后，患者同意再次停药，这次，15名患者中有5名在停药随访中位时间24个月后仍然保持了CMR，而10名患者在停药中位时间2月后第二次复发。
+ _! ?9 O" q8 y    请注意，这些患者都是在第一次CMR后停药然后又复发的患者。
6 Z1 [( O0 N0 t5 j# G1 B
作者：来自法国STIM试验
来源：EHA 2011.6.会议摘要

很不错的文章，看来马老师家有考虑停药的想法了啊！祝福！

期盼易或特也能停药，但现在觉得是一个梦想！

这个非常有意义的研究。能吃下来停会再吃，再停，那是天大的好事