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。7 ~9 @- N9 u6 B V# 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。, k; C9 [3 }' }' s( w$ \/ i7 b
' V- _. {% {8 j5 ?6 L作者:来自澳大利亚
' a0 ?$ M1 \/ ^4 }; D+ Y% a来源:Haematologica. 2011.8.9.' z2 n2 `5 i) {, g! W
Dear Group,! p; d1 t2 U( }# {( v C
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
z4 }' I7 u( |4 w9 b8 X. @0 mtherapies. Here is a report from Australia on 3 patients who went off Sprycel
$ R4 M4 Y, S1 M* P x9 O. @$ b$ @after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
; t3 q1 c( f* a9 h2 R5 ]remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
- r' q$ z0 f2 Wdoes spike up the immune system so I hope more reports come out on this issue.
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The remarkable news about Sprycel cessation is that all 3 patients had failed* K3 p$ I. j: B1 }/ A( [. ^
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
' P- q9 S5 j4 c" I" ndifferent from the stopping Gleevec trial in France which only targets patients) B8 _1 u5 m( ?% h
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 the$ X' S& {& C6 h
response off Sprycel is sustained.
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- ]- i* Z& \% YBest Wishes,
: W! g6 q& W: Q- u8 C" G% X' SAnjana
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( m( J: K) z, r& {Haematologica. 2011 Aug 9. [Epub ahead of print]
8 S1 o, L( g5 |% M3 y- F5 tDurable complete molecular remission of chronic myeloid leukemia following) ?& {" l( v* a" a+ @* t( Y& R
dasatinib cessation, despite adverse disease features.( [0 ?3 A3 E; F( F$ r6 U L
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.& z$ `. }) H2 H& Y
Source
6 g* c7 i6 f! g6 H: e) T8 {( ^Adelaide, Australia;
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Abstract0 K7 k+ ?9 X9 }2 t" f7 c
Patients with chronic myeloid leukemia, treated with imatinib, who have a
% B" j0 r0 M$ m# f; E9 i1 |durable complete molecular response might remain in CMR after stopping
% x# O" f- H" Ntreatment. Previous reports of patients stopping treatment in complete molecular" m9 t0 O8 x+ g
response have included only patients with a good response to imatinib. We
- n& e: ?3 X# P1 n9 |% Rdescribe three patients with stable complete molecular response on dasatinib
7 r; f& Z( Z- Ctreatment following imatinib failure. Two of the three patients remain in; i/ [+ c Y# u2 Q! @4 U# v8 t
complete molecular response more than 12 months after stopping dasatinib. In' M2 D: r9 D( H
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
* }" ~ R) X3 a* j) K/ n2 yshow that the leukemic clone remains detectable, as we have previously shown in/ a, i3 J* R1 U
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as! T v1 @9 m+ m3 o5 v
the emergence of clonal T cell populations, were observed both in one patient
( J5 A1 D! R/ }' g$ u; l9 awho relapsed and in one patient in remission. Our results suggest that the
. V* ?1 _' }! S. _, y" X! {2 C0 _- C) xcharacteristics of complete molecular response on dasatinib treatment may be5 z/ { ~4 R$ i) F: J' }
similar to that achieved with imatinib, at least in patients with adverse
7 e' i* ~3 D9 {7 g* y3 Gdisease features.
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