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。6 e$ `. D+ q8 |2 x& w5 ~4 `
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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5 l) r c# r# O j5 R6 U作者:来自澳大利亚/ R+ t! X" C+ V$ }+ J9 t
来源:Haematologica. 2011.8.9.7 E! w/ i* y$ V s* f- a
Dear Group," g1 B# I" R% O. P5 |
% O! P* t; [. y$ z* }. fSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
; L w% `4 ^8 ^" K0 b2 H+ v; xtherapies. Here is a report from Australia on 3 patients who went off Sprycel! O. y& Q8 O1 t2 o0 @
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
: g; N* m: f' `9 H5 jremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
$ L, p0 _) r% A2 x/ A) a# l0 Ndoes spike up the immune system so I hope more reports come out on this issue.. K: }4 l8 O- C! A
2 J9 x) q+ A* _! i* y
The remarkable news about Sprycel cessation is that all 3 patients had failed! V! T3 n* n/ W% O% T
Gleevec and Sprycel was their second TKI so they had resistant disease. This is8 k; M: u# J+ W# I9 S) d
different from the stopping Gleevec trial in France which only targets patients
1 ~! o/ K' k8 P" ~+ C8 E" n) Lwho have done well on Gleevec.
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: t* x- V; }/ {. c* _Hopefully, the doctors will report on a larger study and long-term to see if the
/ l- I' P/ o S! q4 x* W6 D' Cresponse off Sprycel is sustained.) n1 U4 y8 O2 Y9 a. V7 }
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Best Wishes,
. M6 T- X& ~% n NAnjana2 E2 B9 ?; G0 }- A, j
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Haematologica. 2011 Aug 9. [Epub ahead of print]
, L9 L' V$ h: d# I! P$ RDurable complete molecular remission of chronic myeloid leukemia following
/ t3 i: `. X7 D" j" ddasatinib cessation, despite adverse disease features.
, p" ?' f: P; s& w4 @3 N& oRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.8 v, O, Q4 D3 I# W" O L6 x, x0 a
Source
- }8 a$ }5 ~# ?Adelaide, Australia;
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_1 S, _# P0 i/ FAbstract
9 m ^ ~% T& E2 f( L! J" h& I( oPatients with chronic myeloid leukemia, treated with imatinib, who have a- [! e4 v# T, w& v( p
durable complete molecular response might remain in CMR after stopping3 {5 B) \6 o( \ l
treatment. Previous reports of patients stopping treatment in complete molecular
3 M9 u {/ x) O! m+ |3 H. zresponse have included only patients with a good response to imatinib. We6 F0 F0 G3 [, t1 [
describe three patients with stable complete molecular response on dasatinib
6 c. ?" c1 ^' @1 Z+ Streatment following imatinib failure. Two of the three patients remain in
7 J+ p+ A+ o9 L6 f' Hcomplete molecular response more than 12 months after stopping dasatinib. In
! [7 ]' S& r; J1 v& i4 Othese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to9 h/ Z6 p+ w3 _$ |
show that the leukemic clone remains detectable, as we have previously shown in
1 }' E$ i8 B% Q9 \- R, mimatinib-treated patients. Dasatinib-associated immunological phenomena, such as/ G& T( V+ V% w( N) p! {6 t, i
the emergence of clonal T cell populations, were observed both in one patient
6 @3 s' s% A6 r" X5 i& _who relapsed and in one patient in remission. Our results suggest that the6 f0 ^% ~9 q, B- T9 c; Q# K) |
characteristics of complete molecular response on dasatinib treatment may be
8 a) t z6 O1 h; q3 Jsimilar to that achieved with imatinib, at least in patients with adverse
0 C# `; W% t1 Cdisease features.8 v, i3 B! { a' f$ e# R9 E8 O7 @
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