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。
3 i6 Z, J# V$ } Y7 k: L* I 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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; B$ y+ u/ Z/ j( K9 U% K3 d( K作者：来自澳大利亚
- C. b, e" l# l t来源：Haematologica. 2011.8.9.
: M$ ]3 s" z) N5 @& K; a3 R* ? m; GDear Group,$ _) V' Y3 A7 Y6 V" ~* y7 O( l
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
$ ~& Z/ L/ ?6 ?therapies. Here is a report from Australia on 3 patients who went off Sprycel
& s: x7 w8 G. |3 Iafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
% J- d& P" t: k& ] k+ Gremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
; t$ L2 q4 _5 _; x' }does spike up the immune system so I hope more reports come out on this issue., S7 @! R3 k ], i% W) M
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The remarkable news about Sprycel cessation is that all 3 patients had failed1 F0 E, W. A2 V$ g
Gleevec and Sprycel was their second TKI so they had resistant disease. This is7 E; J: H1 Q& D3 B6 {" L' d% Z
different from the stopping Gleevec trial in France which only targets patients4 J9 m, T2 e7 y8 e$ y1 x) H
who have done well on Gleevec.
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) t, V# U# O) l! `, R0 k5 F% nHopefully, the doctors will report on a larger study and long-term to see if the
0 o2 x3 d! s6 n5 ^% D1 ^4 z, dresponse off Sprycel is sustained.* i' \) z( N, c2 c4 K1 I/ h
+ q J3 s l8 n; y9 C8 a- m i P
Best Wishes,
0 |, `6 Z( x, ?Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]. z4 h) ?4 V0 |9 l3 b
Durable complete molecular remission of chronic myeloid leukemia following
3 i k0 m/ m" b5 Q) Ddasatinib cessation, despite adverse disease features.
5 ?) c9 [4 N6 @4 Z4 H3 V& B0 `Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.4 N& x- a; I& C% D" d
Source- D% ]! x( n0 R9 r- Y( G
Adelaide, Australia;+ d$ D, G1 f& q; r! U, F1 a
P5 P7 C7 i6 F, h. S! h% c% D" eAbstract/ ~; o) f# Q* P+ w1 F$ _7 Y f
Patients with chronic myeloid leukemia, treated with imatinib, who have a) f' y3 B8 n( c/ Q0 @
durable complete molecular response might remain in CMR after stopping
7 B) x o* }. D) `" dtreatment. Previous reports of patients stopping treatment in complete molecular
# q! G: A% S% F4 k& L5 H3 M4 [! \response have included only patients with a good response to imatinib. We8 z3 g$ U, T% D
describe three patients with stable complete molecular response on dasatinib
1 Q2 z: G) _+ n% o; i. d% Ltreatment following imatinib failure. Two of the three patients remain in
5 B9 [. c z a, T) w8 d* tcomplete molecular response more than 12 months after stopping dasatinib. In
5 s7 ]$ p( g9 L- v( p& P3 q+ Q R9 ythese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
; G. F0 B3 g" q5 r: U8 }# q, Nshow that the leukemic clone remains detectable, as we have previously shown in6 }& u% ?2 R [# D
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
$ r3 e& @4 F/ o) w8 v$ ?3 bthe emergence of clonal T cell populations, were observed both in one patient
0 [! d+ t0 `7 a F- m- P0 Cwho relapsed and in one patient in remission. Our results suggest that the
* V1 N( W' k1 R1 z& m: k6 t' Icharacteristics of complete molecular response on dasatinib treatment may be
# n8 G1 ?0 t+ ^$ V& m$ I8 Osimilar to that achieved with imatinib, at least in patients with adverse
% |3 H, f& `$ H4 _disease features.
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