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。
. d) O3 p8 {8 l0 d9 _    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。

6 r5 Q( h- s- g+ ~+ h作者：来自澳大利亚
5 l! D2 s) w5 h8 p9 O% @. F来源：Haematologica. 2011.8.9.
Dear Group,
) s& u$ v" v4 m1 K  r2 Q
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. Here is a report from Australia on 3 patients who went off Sprycel
- Z6 s4 C$ \. w/ W! ?2 ?0 Eafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
does spike up the immune system so I hope more reports come out on this issue.

& L1 g, z: R/ d4 e, hThe remarkable news about Sprycel cessation is that all 3 patients had failed
5 _& F  z( m/ A& E# O  E: aGleevec and Sprycel was their second TKI so they had resistant disease. This is
0 M8 n' J, U* S% i+ [3 b, @' N  Z5 _different from the stopping Gleevec trial in France which only targets patients
( n' M# ^# J0 U* k5 x2 \/ m8 @& B% _who have done well on Gleevec.

Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
7 }% t, Z* i) W0 J  d3 O
+ S. m& j. r! Y0 Y- |2 b) xBest Wishes,
* K; H/ v' d$ h9 u" J4 c; C+ q+ iAnjana
6 j, R4 V' m! W# K" R1 z
- I6 ~1 S: L' i. V6 J% l" z

Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
$ }6 q" _! @" P" Fdasatinib cessation, despite adverse disease features.
& G; U7 m: U/ q( gRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
4 C! d$ }$ h3 d7 Z$ }Source
7 `' V; F" @7 j+ E- B% e$ `5 T& OAdelaide, Australia;

( t, d0 P0 ~/ mAbstract
4 J& ~; w4 x0 b! U6 CPatients with chronic myeloid leukemia, treated with imatinib, who have a
" l& Y, O( B, r( e* pdurable complete molecular response might remain in CMR after stopping
1 J4 {3 o* y5 l2 k4 H/ A1 @treatment. Previous reports of patients stopping treatment in complete molecular
6 H/ g+ X( [0 Z' U3 _response have included only patients with a good response to imatinib. We
1 E3 X$ L+ U1 [! i% jdescribe three patients with stable complete molecular response on dasatinib
9 Q/ Q8 E) V' u- g- ?- P" B" ^treatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
1 Y" U3 |! ^4 B& ^4 c: N: Y7 `these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
" H" R3 l- ~) Mshow that the leukemic clone remains detectable, as we have previously shown in
0 k5 A, a* {) o0 o! y4 r5 limatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
7 `; B) c2 b, W$ L9 fwho relapsed and in one patient in remission. Our results suggest that the
characteristics of complete molecular response on dasatinib treatment may be
) {* [1 }( u9 c6 R- Rsimilar to that achieved with imatinib, at least in patients with adverse
6 B5 G$ N5 Z, }% o' E$ Cdisease features.

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。
) R  ?7 W5 q3 {; b# u    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。
) C  h! ]7 m2 K2 K
作者：来自法国STIM试验
- o5 H0 s! w! q) e6 u3 U! ^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