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。4 d4 F# G% T L- S: F4 Q. Q
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。1 X3 G, D$ h$ e+ T) X: N
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作者:来自澳大利亚
, e' t3 o7 } d, S来源:Haematologica. 2011.8.9., X# t. I2 \" F6 p+ k
Dear Group,
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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.7 g7 I/ A! M+ U4 V) i! u
$ Q5 t% R: b/ P& X/ b1 eThe remarkable news about Sprycel cessation is that all 3 patients had failed8 K8 s3 O6 x& I+ i* v% ~1 i
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.
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Hopefully, the doctors will report on a larger study and long-term to see if the2 o2 T6 f0 X: I' G2 F {
response off Sprycel is sustained.6 W( q/ U' K, p# W
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Best Wishes,
# T) v8 |/ N& bAnjana' `0 V7 o( |* Y- ]' C
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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.; V3 r* H3 ^* S; I( c
Source2 ]* B' X% T* b2 p. [
Adelaide, Australia;& W f4 |8 ]6 d0 m8 R [
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Abstract% _' m7 r$ C, C9 R- t0 [( `/ s
Patients with chronic myeloid leukemia, treated with imatinib, who have a2 Z5 L+ A. I: n; k; H
durable complete molecular response might remain in CMR after stopping; X4 k6 B) i+ a2 b; Q
treatment. Previous reports of patients stopping treatment in complete molecular% P" p2 f' Z2 A: [) j
response have included only patients with a good response to imatinib. We+ X% Z" F9 Q$ L
describe three patients with stable complete molecular response on dasatinib- z# P* |/ a9 d/ {7 M
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$ B3 K" a! C! P% L+ b7 c
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 in8 C7 G- R/ z1 f& F1 n
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.
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