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。

作者：来自澳大利亚
, e' t3 o7 }  d, S来源：Haematologica. 2011.8.9.
Dear Group,
+ F( |% j; t3 P- k
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
. c; L$ W6 W" X1 {4 n, wtherapies. Here is a report from Australia on 3 patients who went off Sprycel
& G4 }- b+ ^* e( p8 Mafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
# T; E+ \, s1 j* n4 U* J. t: Yremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
' p% u( Q; X* t- `. _does spike up the immune system so I hope more reports come out on this issue.

$ Q5 t% R: b/ P& X/ b1 eThe 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
7 y! S; A8 [- y3 @different from the stopping Gleevec trial in France which only targets patients
6 o: ~4 U% I; @. u/ cwho have done well on Gleevec.
/ }0 {# `% x0 E5 d% W4 |3 Y
Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

Best Wishes,
# T) v8 |/ N& bAnjana

  B% Q# M, V3 `7 n

Haematologica. 2011 Aug 9. [Epub ahead of print]
: v( }' x) q8 D2 O+ c+ C) k# h# IDurable complete molecular remission of chronic myeloid leukemia following
* z0 a4 n) L0 rdasatinib cessation, despite adverse disease features.
) y3 o' s8 Z$ Q* v" xRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
Adelaide, Australia;

Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
8 K- s3 }8 t4 ~  Rcomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
# `8 C# \- ~+ b# d. ~/ cshow that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
& ?) A' \- w  {( A, t$ @" bthe emergence of clonal T cell populations, were observed both in one patient
' j. g* h7 ]$ v- h* H: g( n# m% fwho relapsed and in one patient in remission. Our results suggest that the
& F+ t) G" f) b5 [7 o# Ocharacteristics of complete molecular response on dasatinib treatment may be
3 b# X( n/ V+ m# x; f1 ysimilar to that achieved with imatinib, at least in patients with adverse
) X' n+ y# h& P$ A9 D7 I4 cdisease features.
0 I% i. ]  m/ p( \

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。
" [& Q+ [' B( i' f9 v" H8 d    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 r$ L7 n. y3 C- k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