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。

' 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.
Dear Group,

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.
0 G+ U1 e0 |! w: X
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
' P- q9 S5 j4 c" I" ndifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
, w2 t( A" ^4 l3 t2 b
Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
8 L; C; c7 m( y
- ]- i* Z& \% YBest Wishes,
: W! g6 q& W: Q- u8 C" G% X' SAnjana
1 K! \2 ?* X" k5 c' [6 j
% l2 D; A7 p# ~) ?% x

( 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
dasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
6 g* c7 i6 f! g6 H: e) T8 {( ^Adelaide, Australia;
1 u) l$ i; u0 X- H2 F! c  d
Abstract
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
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
complete molecular response more than 12 months after stopping dasatinib. In
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
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
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 be
similar to that achieved with imatinib, at least in patients with adverse
7 e' i* ~3 D9 {7 g* y3 Gdisease features.
/ A% h( D6 h7 d1 T3 H6 `

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。
    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。
# P) l6 A( ]* {7 T$ K
8 T% h% k  [& i& T8 u' z# A& A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