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。- ~& ]# x, T5 u5 [" G4 Q
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。9 k, D Z, `+ s* G/ [! Y
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作者：来自澳大利亚/ o8 V6 `7 a- m: I5 D5 u E7 W2 N- l* U
来源：Haematologica. 2011.8.9.
' B. x) @5 J% |; a8 B: dDear Group,$ v3 j/ A' W" ]4 r0 b- E" V
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML! H' V. v/ a2 O8 g, `- `/ |
therapies. Here is a report from Australia on 3 patients who went off Sprycel3 f2 k( T: p7 o7 [) {
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
" |6 n- `- N8 G# Nremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel/ z. s; }/ h5 O/ W% z
does spike up the immune system so I hope more reports come out on this issue.
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1 G ]. ^/ _; ~The remarkable news about Sprycel cessation is that all 3 patients had failed
: U# n4 X1 Q- h+ m9 U2 |- qGleevec and Sprycel was their second TKI so they had resistant disease. This is: q- c: ~4 a! [/ V) }% L8 y
different from the stopping Gleevec trial in France which only targets patients+ @( F; A# z. H+ |/ {9 K
who have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the0 Y: h0 }0 ?; G3 e( y+ m1 z- N
response off Sprycel is sustained.
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- ]6 [# I+ }. Q* XBest Wishes,* d( U0 Y, R* E& l/ a5 Z% M
Anjana1 D* m2 H; e9 a9 ~9 @. C3 ^
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Haematologica. 2011 Aug 9. [Epub ahead of print]
* d( K; S, W& FDurable complete molecular remission of chronic myeloid leukemia following
. s- u5 F( F0 o1 ]dasatinib cessation, despite adverse disease features.
7 f' X1 r* Z5 l$ G) t3 nRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.3 Q6 A+ q& f! g9 G, A
Source
; x! f# a2 d- \& [6 S+ Z2 ]. ?Adelaide, Australia;8 Z* P# B. K2 W
/ i% D v$ {3 R/ Z+ \Abstract
G) j3 m$ \. @/ @7 EPatients with chronic myeloid leukemia, treated with imatinib, who have a! ^, Q" _2 T& p1 M8 I I. f6 X
durable complete molecular response might remain in CMR after stopping
/ _9 L5 Y9 X+ Atreatment. Previous reports of patients stopping treatment in complete molecular
, @! L0 |# R$ X" S. Nresponse have included only patients with a good response to imatinib. We; m) u1 Z2 _/ `8 g: q+ j
describe three patients with stable complete molecular response on dasatinib
. T/ q; O" C% _% `! streatment following imatinib failure. Two of the three patients remain in2 ~: Q5 S6 u1 ~0 _
complete molecular response more than 12 months after stopping dasatinib. In
2 k5 l' f" L ]- }+ Qthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
( v( v; ?: U9 O7 v3 I5 S, T# H2 i+ |4 v' eshow that the leukemic clone remains detectable, as we have previously shown in5 p% D/ H+ _% ~. W: \9 S
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as% i3 V! I g" ^( B7 g
the emergence of clonal T cell populations, were observed both in one patient
7 Y0 v( b; ]$ p S) Mwho relapsed and in one patient in remission. Our results suggest that the
, e3 D% H7 [: l& `* lcharacteristics of complete molecular response on dasatinib treatment may be4 [% P% z0 G, V! F9 M
similar to that achieved with imatinib, at least in patients with adverse$ x; W* n+ r/ A0 k
disease features.& w$ ^5 t# w4 k! l
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