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。
0 {; Q4 y9 ~. [ 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。8 a" T4 f1 o- m! z
) H- u5 L* h& `' f6 V* T P0 q作者:来自澳大利亚# S0 ]1 k+ s9 T [- n" x* Q6 h
来源:Haematologica. 2011.8.9.
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4 ]8 W& C7 H1 E3 Y6 v7 kSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML" K: I0 `2 ~5 k. b* w! n
therapies. Here is a report from Australia on 3 patients who went off Sprycel) |- |' l- p+ d
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients/ t) a( E/ ^4 R: x8 X5 K# ~4 h% q* C
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
' ~# r* Y+ X3 x* x) _$ p2 G. Jdoes spike up the immune system so I hope more reports come out on this issue.
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5 C5 L9 }3 I/ c' ]The remarkable news about Sprycel cessation is that all 3 patients had failed& ?+ A+ y) ~7 Q& D- d/ [2 u8 @
Gleevec and Sprycel was their second TKI so they had resistant disease. This is( i$ K3 Y3 p' Z/ Z- \ w `: y
different from the stopping Gleevec trial in France which only targets patients- @( f8 `9 M) G3 _) i/ C
who have done well on Gleevec.! k/ r" K; u# q# i/ q
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Hopefully, the doctors will report on a larger study and long-term to see if the
Y, t! L! s- C9 B% k4 Z+ n" rresponse off Sprycel is sustained.$ c' q3 W( X+ W9 h
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Best Wishes,8 b, A3 Q7 c) S) Y% k% Y: N8 K5 P
Anjana
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# d1 ]1 {+ V9 r WHaematologica. 2011 Aug 9. [Epub ahead of print]2 S' W7 x" \- a K: Z
Durable complete molecular remission of chronic myeloid leukemia following# w2 F2 q5 E0 L/ E$ B
dasatinib cessation, despite adverse disease features.. v5 d! ]; `) G1 y, _$ ^3 {6 d- P
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.3 _% o0 K4 z: j9 j$ P$ Y
Source3 E5 f! R# I# j
Adelaide, Australia;" k( b0 M% s( |
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Abstract9 \& T: W9 l4 ]$ f; H( u
Patients with chronic myeloid leukemia, treated with imatinib, who have a" t$ S" ~. d+ @7 n
durable complete molecular response might remain in CMR after stopping
. z. j, l" o9 R4 A2 C3 ctreatment. Previous reports of patients stopping treatment in complete molecular
: @8 b6 ~5 `8 ?response have included only patients with a good response to imatinib. We2 Z0 B7 P: G! f5 _
describe three patients with stable complete molecular response on dasatinib7 R2 P7 z5 N b0 N6 j' D
treatment following imatinib failure. Two of the three patients remain in+ l8 u. y; {$ j$ h% [
complete molecular response more than 12 months after stopping dasatinib. In
! U0 Y. x A, W) V8 d7 kthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to M( w, C; [' _( f
show that the leukemic clone remains detectable, as we have previously shown in
( F' W0 F) I" ~: M6 S% \imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
# @ X) y; l5 C, @. g. M# \the emergence of clonal T cell populations, were observed both in one patient( ~8 y$ {1 j5 `. m
who relapsed and in one patient in remission. Our results suggest that the
" I, `6 p; l# E1 }characteristics of complete molecular response on dasatinib treatment may be( J x; O& k5 A! D
similar to that achieved with imatinib, at least in patients with adverse) H) f! ^* F& r/ p! L! z9 L: I
disease features.
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