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。% ^& @1 i0 W2 q/ K
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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9 L! L: j8 H2 m0 p作者：来自澳大利亚. C T; Z/ u$ r0 k7 ~
来源：Haematologica. 2011.8.9.# f8 F/ K! p2 \4 _( o) T
Dear Group,
% Z( |- k v! u
7 M. r: | A' S1 q) h* eSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
% e* V! c+ Q! Ntherapies. Here is a report from Australia on 3 patients who went off Sprycel# x/ O5 {; z$ Q
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
6 W: D+ @1 |( i. g& T2 h3 L+ `4 ]remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel% @" P) p2 r$ Z9 m- ^
does spike up the immune system so I hope more reports come out on this issue.
+ e: @. O$ r! g( ^" i/ g/ c4 ]8 r8 X
The remarkable news about Sprycel cessation is that all 3 patients had failed8 E7 i- h, V. i _8 F7 l, y
Gleevec and Sprycel was their second TKI so they had resistant disease. This is2 h2 Y' N1 S- |& g2 D% b) ]
different from the stopping Gleevec trial in France which only targets patients
% @7 g4 H0 D C( r+ |; L: D' ?who have done well on Gleevec.: n% j0 f- d- i% X( x& ^
' g; q3 k7 o0 h! sHopefully, the doctors will report on a larger study and long-term to see if the
; L+ Q" y5 Q! ^% m2 z0 g8 lresponse off Sprycel is sustained.
- C0 U+ Y2 D' e, V8 Y5 q) C t& z9 h* O& |
Best Wishes,
8 j! \* r4 t8 E% R. |/ lAnjana
$ O, w/ \3 l1 Z3 O4 T/ }* Y( V, |( K* W2 i# S
; D7 }! d6 |: j2 _' N( c
8 ]; j' Z3 [ u9 K GHaematologica. 2011 Aug 9. [Epub ahead of print]) r- J8 h! [/ Q+ d# j
Durable complete molecular remission of chronic myeloid leukemia following
" e L7 _; ?& C' i& mdasatinib cessation, despite adverse disease features.! ~ a1 |5 F5 K+ {
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
9 N9 }/ y! e- o% g6 J" SSource
8 k+ {- E+ d( ~! _, F4 ZAdelaide, Australia;; ^3 J' M1 G1 O
4 `# x% x6 S8 J# AAbstract" `! W* @8 {* O- m) i9 [: @
Patients with chronic myeloid leukemia, treated with imatinib, who have a
7 d7 @4 D# I/ o$ v1 Zdurable complete molecular response might remain in CMR after stopping7 I" e) J: L4 D( {. ~2 K3 P
treatment. Previous reports of patients stopping treatment in complete molecular
3 m: f) G* D6 w* A4 yresponse have included only patients with a good response to imatinib. We( |: {6 ?9 d, F6 b* f
describe three patients with stable complete molecular response on dasatinib- w. o8 m( b- ]+ N) }
treatment following imatinib failure. Two of the three patients remain in3 y# Z; y! w8 `1 @
complete molecular response more than 12 months after stopping dasatinib. In
8 f3 v6 m( ~0 K9 u2 D9 `+ {these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
3 D1 n8 y h: g- C$ Nshow that the leukemic clone remains detectable, as we have previously shown in0 d! k' R+ @) ]2 A
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
6 d1 F4 A f4 e1 [& Qthe emergence of clonal T cell populations, were observed both in one patient, k! Y9 q3 }( T& K8 w8 V8 `2 S1 Q' T3 t
who relapsed and in one patient in remission. Our results suggest that the
( [( M0 `( w) `6 [& ~/ n4 K5 kcharacteristics of complete molecular response on dasatinib treatment may be
$ X' g( h* F s+ P5 m, x X. o% _1 V) tsimilar to that achieved with imatinib, at least in patients with adverse9 d+ N2 Q1 b( q$ S. K2 K5 w
disease features.% p2 t2 \4 b0 t1 ~7 ~9 w1 x2 l2 X
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