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。
    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。

作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
9 W$ C/ U% |: t) Z3 e& PDear Group,
3 Q2 ~; g9 D$ ~% W/ j6 C
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
3 v2 i6 y- \1 r0 wtherapies. Here is a report from Australia on 3 patients who went off Sprycel
( B7 H, H$ {, ~1 F( ]+ ~after 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
( O$ C' c4 B' ~/ k! Udoes spike up the immune system so I hope more reports come out on this issue.
' E# T% l/ J# `0 N+ R3 G
The remarkable news about Sprycel cessation is that all 3 patients had failed
. W+ N0 _& E& `. C! Z8 A, B9 `Gleevec and Sprycel was their second TKI so they had resistant disease. This is
. B# l( u& T$ `  M( x) A  k5 s$ g' wdifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
! U9 `8 l% u* S1 ~  P* l6 \
9 ]1 x# t. e( S# @$ |6 FHopefully, the doctors will report on a larger study and long-term to see if the
- u1 e6 I$ A5 ~, j) ~3 G' I: qresponse off Sprycel is sustained.
& A$ d! w5 x6 [2 T* L% \1 t
! u" q3 l* {6 e0 e; eBest Wishes,
& t) ^8 ]+ e4 j4 x2 H: WAnjana


  O! C5 L' z, O0 d% \9 j
Haematologica. 2011 Aug 9. [Epub ahead of print]
+ o2 `% k7 F6 n- j2 |6 ?Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
  U+ R  }) N; @% f6 w9 XAdelaide, Australia;

- P. c- M# p8 s$ l! x1 W- B% J; rAbstract
( Y) [; c& k0 K$ n# \* G  R! fPatients with chronic myeloid leukemia, treated with imatinib, who have a
9 C1 x/ h0 A$ Z' N6 \durable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
( }" h. s: k3 @0 cresponse have included only patients with a good response to imatinib. We
  K4 _' z8 F$ e1 K5 {describe three patients with stable complete molecular response on dasatinib
" q( e* K9 G4 R2 y* b, Ftreatment following imatinib failure. Two of the three patients remain in
; n- Z3 Q! T$ m' K0 rcomplete molecular response more than 12 months after stopping dasatinib. In
7 d4 F4 Q$ G0 kthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
show that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
' @/ o/ B' h! }8 r( h8 {" q" V' H$ m' Rthe emergence of clonal T cell populations, were observed both in one patient
* {' W8 ^9 r8 i0 Q* m* Qwho relapsed and in one patient in remission. Our results suggest that the
6 @) r1 J! F2 a; Pcharacteristics of complete molecular response on dasatinib treatment may be
) C. g) S2 w' L$ t) Q5 z* r" Zsimilar to that achieved with imatinib, at least in patients with adverse
disease features.
3 |, O& t8 y5 V( v

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。
- y* F: w# l8 E. I' X" {/ D/ V4 z    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。
    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。

1 v# j9 j+ [/ L# t" V4 G作者：来自法国STIM试验
8 ?/ D5 O& a/ J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