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。
( i+ g! M+ I: G. q6 ^) h4 I* q! r    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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作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
! B& B, r3 A: T! T+ ADear Group,
8 A- h: F/ w" K% r4 I3 G0 H4 _5 c
. [; k4 f& e) ^7 vSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
& F+ c. p% [7 f( e+ u5 [9 w8 Ntherapies. Here is a report from Australia on 3 patients who went off Sprycel
, y9 N* E9 `% K/ pafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
9 R. y1 C' W# Xremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
does 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
6 ~& X7 U: l+ z) G2 l0 f7 wGleevec and Sprycel was their second TKI so they had resistant disease. This is
0 N1 ]8 R4 T3 w+ Kdifferent from the stopping Gleevec trial in France which only targets patients
0 c# L( @+ h+ s+ ]0 |who have done well on Gleevec.
+ Z. Q& S- N# K% E2 t. v
5 b/ E7 ]; B# I$ g) n; |Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

- ^( _- X  q4 HBest Wishes,
Anjana



Haematologica. 2011 Aug 9. [Epub ahead of print]
. M* g  p, A7 GDurable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
) s& N, q& F9 G$ c9 z: g$ A# m1 wRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
& o. }9 L4 ~# v  g( O) ~Adelaide, Australia;

) K4 E" F+ N# qAbstract
3 M$ E9 E, \3 p4 x* b# }2 UPatients with chronic myeloid leukemia, treated with imatinib, who have a
) d) L: a. W3 h& l$ F9 T$ pdurable complete molecular response might remain in CMR after stopping
6 w. k) m6 ~+ t, A  v* s! b4 k! ~treatment. Previous reports of patients stopping treatment in complete molecular
. Q1 @) g8 m+ w7 v8 `9 F) Z) sresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
) S# H& v) U# a. @- H% g) W. Etreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
  p, |; L( b- ^+ C- qthese 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
7 s* R  [' c$ H& ^# Bimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
who relapsed and in one patient in remission. Our results suggest that the
1 {+ I; R$ q8 kcharacteristics of complete molecular response on dasatinib treatment may be
3 R* h" [5 \/ E+ Ssimilar to that achieved with imatinib, at least in patients with adverse
1 Q7 p9 v0 S- t! ?& x* bdisease features.
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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。
/ q7 I! n$ S' t, n3 R    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 k1 Q9 H' P7 f) @) s    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。
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4 D% S  E0 v* P3 {; ?: r作者：来自法国STIM试验
; Q% A  X# ?) U% E; D6 o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