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。- j% p: }/ Q) c8 k
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。
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! U6 y; ~/ d3 v0 v$ I5 w* d作者:来自澳大利亚+ p7 L2 W& G0 t( B' M( [
来源:Haematologica. 2011.8.9.
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
' |" q; V9 p7 @! Y7 vtherapies. Here is a report from Australia on 3 patients who went off Sprycel1 U l2 Y9 I1 n
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
' h, \" q; |: T) A1 d9 Iremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel# i' \+ b% f" j. d4 G
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
6 }* T+ r* C* l9 [* y, ^Gleevec and Sprycel was their second TKI so they had resistant disease. This is0 M% y# F! h; b
different from the stopping Gleevec trial in France which only targets patients7 |8 f* e4 \6 d5 n# R; e) u
who have done well on Gleevec.: i" r: A" H {6 V: s i5 Y+ g
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Hopefully, the doctors will report on a larger study and long-term to see if the/ y- d( s% O( l- T7 Z) v
response off Sprycel is sustained.5 c% R2 l; d2 ]6 D
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Best Wishes,
3 r* N$ a7 j& S2 o8 j" cAnjana
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: E' ^! J N" [! J" S y" UHaematologica. 2011 Aug 9. [Epub ahead of print]
9 f+ C/ N9 h$ k- H8 h; ZDurable complete molecular remission of chronic myeloid leukemia following
/ v+ u+ ^1 a$ @( Gdasatinib cessation, despite adverse disease features.1 t' N% a5 _. n$ Z: r( n2 [- B
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.0 {' i$ j( Z& J$ P* s
Source
$ v+ W, }5 ~: ?$ T6 R/ GAdelaide, Australia;, `0 b/ m: e: K- o1 }; \9 Y
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Abstract
. x- J: m+ S; E8 zPatients with chronic myeloid leukemia, treated with imatinib, who have a/ L" ~) Q: U; W/ X
durable complete molecular response might remain in CMR after stopping5 |( n1 T5 }) s. D
treatment. Previous reports of patients stopping treatment in complete molecular% i) m+ A: Y) u
response have included only patients with a good response to imatinib. We/ d( Q6 e& R& G2 G0 E z: J
describe three patients with stable complete molecular response on dasatinib( g( p. E7 P) c% `; g1 w
treatment following imatinib failure. Two of the three patients remain in
S% t2 |6 ?3 I7 V$ Wcomplete molecular response more than 12 months after stopping dasatinib. In+ t1 R( K3 }) a
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
! L B. V4 I% ]! n- K8 qshow that the leukemic clone remains detectable, as we have previously shown in+ a+ ^( l' C5 P/ Y
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
+ u2 [6 O2 m* M4 T3 Q! t2 m3 _# Wthe emergence of clonal T cell populations, were observed both in one patient
3 }0 }) p4 Z( h; c& bwho relapsed and in one patient in remission. Our results suggest that the/ w& W7 j. l$ ^+ Z( T
characteristics of complete molecular response on dasatinib treatment may be; }! p, E% j) q7 I4 `& W; M
similar to that achieved with imatinib, at least in patients with adverse, R, u7 Z( W3 f4 ?6 R! ], b
disease features., e4 S( G$ H/ d( w0 w, u' ^. h8 _
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