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。
) j5 F( V, P& d: S' W9 [# Z    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
( p- }8 q2 {2 Q来源：Haematologica. 2011.8.9.
. R: C0 m0 C& X5 j+ ~  P5 kDear Group,
' [: M. Y1 z. q! o
3 |' {1 c! Z7 ~8 C- H" ySome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
# b" _( Q- W- b8 K8 f. z: e2 otherapies. 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
does spike up the immune system so I hope more reports come out on this issue.
) A8 X. E/ E; l: v! e3 k0 S- n
& c- l6 A6 o# C2 ^* ~* dThe remarkable news about Sprycel cessation is that all 3 patients had failed
% p( D  V% W; Y1 n* fGleevec and Sprycel was their second TKI so they had resistant disease. This is
; E2 c( }2 w' P) S: i1 Kdifferent from the stopping Gleevec trial in France which only targets patients
. ~& U' ]) @- t' F- v2 b, ?who have done well on Gleevec.
% Q" m0 e! t$ s
Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
1 r% P8 |: {! X: _. R
7 U+ F, ]% e* ~7 bBest Wishes,
! ?! l- N" R/ z  J% O1 h# {* wAnjana


7 z3 L6 f" S8 O
Haematologica. 2011 Aug 9. [Epub ahead of print]
6 u+ A3 ^  y: M2 V- PDurable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
+ z- x% i% o7 LRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
" b4 p% ]; U3 U0 L# H, YSource
Adelaide, Australia;
3 a3 p, f9 c% w9 D2 s
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
9 C6 G. Q( O* S# V$ K% ]$ [( aresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
8 ~- L8 y& }2 g) {: J  [. ftreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
7 ~. U9 m9 g% }. ?! G& ~these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
4 O' |3 |- ~4 w1 g1 a9 Y3 ]show that the leukemic clone remains detectable, as we have previously shown in
" K' t4 ~& B/ J' }/ w. _" _# f+ Nimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
; D4 Y. R  S  i( F0 w& Zthe 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
/ Y2 P  S5 u, h0 jcharacteristics of complete molecular response on dasatinib treatment may be
  e% D" @: O$ Fsimilar to that achieved with imatinib, at least in patients with adverse
' Q) j' }% N: F9 N8 Zdisease 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。
" r+ ~/ u4 |. M5 ?! z$ P    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。

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