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。 R: Q" W" W( v! f) b1 G
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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R& A5 A, \3 n作者:来自澳大利亚5 x- Z$ z4 G9 P4 x' i i6 A* B
来源:Haematologica. 2011.8.9.+ R2 x1 H! x) F( p3 v# \# x6 a
Dear Group,
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* E2 H0 s) i$ n6 NSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML2 \% }5 ^# V$ Y* V) f9 f8 O
therapies. Here is a report from Australia on 3 patients who went off Sprycel a9 i8 ?7 G" F( X
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
# l7 F: H! E* o! `# ~# O, mremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
. R$ G4 {0 ^* [8 x0 M/ jdoes spike up the immune system so I hope more reports come out on this issue.3 ? n, ~, g! J1 L! a4 _2 H
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The remarkable news about Sprycel cessation is that all 3 patients had failed; M. M& {9 n2 T) |4 H
Gleevec and Sprycel was their second TKI so they had resistant disease. This is5 y/ n( k+ E. a( P3 L. J0 {; B# u
different from the stopping Gleevec trial in France which only targets patients
( \6 z6 T; O! m, Hwho 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
& y/ p7 l& b# f, ^7 jresponse off Sprycel is sustained.
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+ P8 g3 R5 q0 J6 j2 y" }Best Wishes,( [7 \- z6 ^0 q6 E
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
- D" a4 i' m6 Q' ]7 nDurable complete molecular remission of chronic myeloid leukemia following
& F' q E, w- a3 J% G6 }$ ]; S8 tdasatinib cessation, despite adverse disease features.+ r. v9 K9 [+ I( A, ~& v; A
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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Adelaide, Australia;' x* P# X! @/ n5 X
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Abstract
, I7 t6 b0 h/ i# Q0 K5 jPatients with chronic myeloid leukemia, treated with imatinib, who have a
7 k" k; w0 T f* c5 y$ Q) g/ Hdurable complete molecular response might remain in CMR after stopping
' B7 Q9 x* Y& n* ^) I" Ttreatment. Previous reports of patients stopping treatment in complete molecular
0 g& V$ C% F3 k. ?; nresponse have included only patients with a good response to imatinib. We: v( V# W7 [. L; v5 `* S7 o( w$ q
describe three patients with stable complete molecular response on dasatinib* p8 i4 ^7 D4 F- N* k
treatment following imatinib failure. Two of the three patients remain in o& p5 l: L8 h p1 D. ?8 X+ n
complete molecular response more than 12 months after stopping dasatinib. In5 e) R( `, t; ]4 b
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
2 p/ q8 e1 r/ o+ x3 jshow that the leukemic clone remains detectable, as we have previously shown in
% Q7 P- s) l. R: v- I4 I& r' c0 uimatinib-treated patients. Dasatinib-associated immunological phenomena, such as' e% J! M, ^( Q
the emergence of clonal T cell populations, were observed both in one patient, `( j# p! T- T. l+ `' H. k
who relapsed and in one patient in remission. Our results suggest that the
$ l; g" S7 N% t* I) n2 Jcharacteristics of complete molecular response on dasatinib treatment may be
% s w$ t* d! B- _similar to that achieved with imatinib, at least in patients with adverse
3 C9 N: \+ C$ g& idisease features. J: o! J7 B" ~0 F; y" Q2 Y' V. M
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