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。
    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
来源：Haematologica. 2011.8.9.
Dear Group,

% 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
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.

The remarkable news about Sprycel cessation is that all 3 patients had failed
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
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.
9 i& H3 u) d6 J1 }, C6 t' c
: 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.

Best Wishes,
. M6 T- X& ~% n  NAnjana

2 z, ]% F; j- q8 X0 I  H
5 b- q! ?( N+ L; A
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.
Source
- }8 a$ }5 ~# ?Adelaide, Australia;
' ?2 n( l/ [! @/ u7 X
  _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
durable complete molecular response might remain in CMR after stopping
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. We
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 to
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
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 the
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.

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。
0 G3 B# j: w  r8 f    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。

. T/ ^, d. X* a+ W3 l7 t作者：来自法国STIM试验
: I% U: t; C; p, {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