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。
/ H9 s t- E2 ^ 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。/ |; m4 R# ~0 b: X( s* l$ Q( W
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作者:来自澳大利亚- \- S; }0 w& K h2 t# F
来源:Haematologica. 2011.8.9.1 M; ^' R5 f4 @6 W; {3 K
Dear Group,/ Q i- @) D. X
x3 b0 |& l& q/ g9 c+ k3 z J4 [Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
0 m9 K9 K" ? h$ b: ?, e! itherapies. Here is a report from Australia on 3 patients who went off Sprycel& P1 j7 M# w' a" [5 A: U
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients h: E4 [+ P7 R s5 h3 e6 ?
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel& k9 Y3 c4 B0 q7 {- ]
does 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
* ?+ |4 H# ], K* i! PGleevec and Sprycel was their second TKI so they had resistant disease. This is& F; v- W/ ]2 [3 _" G
different from the stopping Gleevec trial in France which only targets patients3 i- ?3 a0 g! k: [- ?
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
# \$ c% W. s! bresponse off Sprycel is sustained.7 a! D1 P& l9 F( O/ D
$ w! n" T# |- S/ NBest Wishes, K1 S6 y5 F/ e: g+ u3 t
Anjana
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: i1 e" ^' g3 s( {' AHaematologica. 2011 Aug 9. [Epub ahead of print]" l! g2 Y' p' Y' @ W' N4 T
Durable complete molecular remission of chronic myeloid leukemia following
% z. z$ s1 w/ p* e; B- idasatinib cessation, despite adverse disease features.
$ Q, |' S8 P9 J/ iRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.1 Y( c% T# k% `, t2 a+ B6 @; e3 {
Source; g+ n* W9 a5 t( Y9 p0 A
Adelaide, Australia;
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# N9 P. y3 W5 N- Y* H! wAbstract
9 x' r. p+ ]# b& u3 S b7 EPatients with chronic myeloid leukemia, treated with imatinib, who have a
$ g& W8 ?# w; S# Q3 gdurable complete molecular response might remain in CMR after stopping+ F6 ^3 ~. Y/ x3 K; O) C! Q
treatment. Previous reports of patients stopping treatment in complete molecular
" {/ }. g( ^/ w% b0 H$ f% Eresponse have included only patients with a good response to imatinib. We
) Q9 F4 i2 }9 O% Vdescribe three patients with stable complete molecular response on dasatinib, n+ ^! g# r7 b8 J8 B7 N
treatment following imatinib failure. Two of the three patients remain in
' e% @7 H$ L4 B- _3 e0 tcomplete molecular response more than 12 months after stopping dasatinib. In1 @; J9 d3 R2 P
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
/ `# u) r: Q/ S, v$ x6 B$ g3 L$ gshow that the leukemic clone remains detectable, as we have previously shown in
: d6 B4 E- m Z8 K8 `imatinib-treated patients. Dasatinib-associated immunological phenomena, such as4 A3 W: A# `$ S+ Q- L" h4 B& v
the emergence of clonal T cell populations, were observed both in one patient
& n9 p+ l6 k/ n+ S+ o7 Dwho relapsed and in one patient in remission. Our results suggest that the
: R% R: x8 @& a# c+ zcharacteristics of complete molecular response on dasatinib treatment may be
8 D. ?; [ F3 Z( B8 g3 Psimilar to that achieved with imatinib, at least in patients with adverse, U% ~1 i: L: j
disease features.
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