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。% K) F: k0 Q1 n
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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7 x, t) }: d% {6 H, o6 o作者:来自澳大利亚
+ i. V$ I; t# `" }- a来源:Haematologica. 2011.8.9.
7 L% n7 h8 k2 X( u, @+ `Dear Group,; v) s% X3 i- ~* m6 ~, V
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML, A; q2 c; F! V$ ~4 z
therapies. Here is a report from Australia on 3 patients who went off Sprycel8 h1 w# i! ]3 h: n; D3 A* I
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
* u$ I, e/ r) k* }0 F6 Iremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
# W, j5 @1 ], pdoes 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
/ t1 q S2 y' u) m; AGleevec and Sprycel was their second TKI so they had resistant disease. This is
/ V1 c* H4 n# ]# odifferent from the stopping Gleevec trial in France which only targets patients: P9 }( f% T8 u' X
who have done well on Gleevec.5 D4 l: f8 |0 o/ i8 T/ \
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Hopefully, the doctors will report on a larger study and long-term to see if the
1 _8 s& S. @# mresponse off Sprycel is sustained.
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$ f/ v& T# [% w$ I& s' q$ y# yBest Wishes,6 l& ~1 x, k2 N7 W; Y% I, L* p
Anjana2 O+ S# u& {# L M- F2 M3 Q* t1 @% |
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Haematologica. 2011 Aug 9. [Epub ahead of print]
" L% d9 R: H9 s, UDurable complete molecular remission of chronic myeloid leukemia following6 L+ l" u- }7 k) Y3 W1 X H
dasatinib cessation, despite adverse disease features.8 x$ W9 R7 l0 ~6 v& n. s7 W
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.7 ?5 o9 _' O& R
Source7 I/ W3 ?- q" v1 j. n g
Adelaide, Australia;. ?6 e5 N6 @# s( \7 H R7 A1 P3 _
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Abstract
1 m1 d1 I# `$ C0 A5 xPatients with chronic myeloid leukemia, treated with imatinib, who have a
# Y- R8 k' B1 n# F5 r! i1 P2 Ldurable complete molecular response might remain in CMR after stopping$ E/ d8 x! m: A1 c* o& s. x
treatment. Previous reports of patients stopping treatment in complete molecular2 b8 E9 `& L. n* p9 ^/ }2 W; |6 i
response have included only patients with a good response to imatinib. We
3 O6 ^$ M/ s) v6 r4 Ddescribe three patients with stable complete molecular response on dasatinib
3 Z5 I! R, R% E* P3 @9 C1 l. ^treatment following imatinib failure. Two of the three patients remain in
0 g* u4 X8 v0 r! n! Gcomplete molecular response more than 12 months after stopping dasatinib. In
! ^4 ~0 N) O( y! J( c' ^+ ~) s. d8 wthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
; B4 C/ J+ ?- j6 N# {show that the leukemic clone remains detectable, as we have previously shown in( J* Z* ? o2 p9 w
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as* g4 X/ s+ R+ `7 y; e
the emergence of clonal T cell populations, were observed both in one patient
) O9 e7 V8 p) c/ }; o* wwho relapsed and in one patient in remission. Our results suggest that the% {" F' x- y: S4 p5 S
characteristics of complete molecular response on dasatinib treatment may be& S3 a4 b5 x, I) w3 R% d
similar to that achieved with imatinib, at least in patients with adverse7 M9 j+ L# V8 f6 `9 b1 n
disease features.
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