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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! f+ m1 J+ `4 F( x! h* l( n- s作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
, W3 `" z. O5 [( s6 |4 U% ?Dear Group,

Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. Here is a report from Australia on 3 patients who went off Sprycel
! `& L; `7 J. ]7 S6 Z  k& }3 ]after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
remain 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.
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; y& |2 l/ G/ q0 T' ~6 @6 ZThe remarkable news about Sprycel cessation is that all 3 patients had failed
& c( \6 ]: W4 ^# P+ ?; bGleevec and Sprycel was their second TKI so they had resistant disease. This is
. k: z6 F) R0 F7 edifferent from the stopping Gleevec trial in France which only targets patients
4 m5 g( x9 E) O& x1 h$ Rwho have done well on Gleevec.

Hopefully, the doctors will report on a larger study and long-term to see if the
& k7 j8 W" z4 {6 p8 [response off Sprycel is sustained.

Best Wishes,
Anjana

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# ]: @* Q& [& k; C: x; Z5 N# g9 mHaematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
6 |9 Z- O. ~3 R- B1 DRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
8 o- T  s' Q1 H: s9 sSource
Adelaide, Australia;

6 I3 N5 K4 V  a( z9 J1 [. L  YAbstract
Patients 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
( a! T7 j1 E0 s, B5 A% @4 H% Oresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
7 w8 _% o4 ]9 B; s( Z- d/ D& Fcomplete molecular response more than 12 months after stopping dasatinib. In
  t" r9 S4 c! V5 X! R$ Ythese 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
imatinib-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
5 K$ t: u. }2 B1 s4 b0 Qcharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
: S, W9 F. @8 }: ?1 [* Adisease 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。
0 r) H+ L7 k+ o3 F$ G    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。
    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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5 X9 J2 Z) j4 w+ j! l- ?# M4 j作者：来自法国STIM试验
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