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。

, {2 `' Z& M) h8 a$ p作者：来自澳大利亚
- ^( D7 `) F& v1 e来源：Haematologica. 2011.8.9.
1 K& _0 l3 W- C0 {: K- oDear Group,
0 _4 w  I' g+ |, m8 ~
; p6 O% p9 ?0 J8 }# MSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
6 ~" a% z& l: t3 B6 D6 M6 {therapies. Here is a report from Australia on 3 patients who went off Sprycel
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
0 p. {. R! a( X1 l' F: L; fdoes 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
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
& i$ [9 u. k$ ]+ Odifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
% @7 M) }3 G: z$ t! @1 L8 W, O
Hopefully, the doctors will report on a larger study and long-term to see if the
0 L0 i' \4 Y/ Q( o* Iresponse off Sprycel is sustained.

Best Wishes,
Anjana



1 c2 A/ y4 f5 y- m# i- I$ K7 t- OHaematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
9 M- ?% r- P. [# Udasatinib cessation, despite adverse disease features.
; m2 X6 {+ T; J3 W* GRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
Adelaide, Australia;

Abstract
' z' E* a7 ~" T( PPatients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
5 \" p* ?, U" ttreatment. Previous reports of patients stopping treatment in complete molecular
response 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
, q) O) k% t) C! X* S( Icomplete molecular response more than 12 months after stopping dasatinib. In
these 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
* B) R: `( w3 A1 S+ m6 ithe emergence of clonal T cell populations, were observed both in one patient
: d* o! e. [' Kwho relapsed and in one patient in remission. Our results suggest that the
$ M7 X% a9 o8 Z- kcharacteristics of complete molecular response on dasatinib treatment may be
4 s6 P* y: O+ D5 ?similar to that achieved with imatinib, at least in patients with adverse
2 q, c# N/ ]1 E4 g: hdisease 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。
    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。
" X0 H$ b+ h, ^' t7 U/ P, q    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。
" q" i) L4 H  j6 L
% A% T  ~& n: n+ f6 i. }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