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。
: U; S( Z. d( b. x5 t- t8 G3 c, ] 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。: S# @) c) q9 {
/ e, _, t! Z8 q r作者：来自澳大利亚1 o f, O3 s5 L
来源：Haematologica. 2011.8.9.& n, \! \% n9 @- u6 H/ {0 A6 {4 ]
Dear Group,$ c4 h" ~: Y* M3 g9 ?" J6 @% [
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML3 N4 ?' ]2 f1 v
therapies. Here is a report from Australia on 3 patients who went off Sprycel
. { T9 U. r7 |' m" V* Y, Zafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
# x' Y7 W. d( ]* T( Eremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel- z1 u5 H) j: N1 U
does spike up the immune system so I hope more reports come out on this issue.
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& n7 k u6 p/ o9 z1 P" m9 R5 m+ P, SThe remarkable news about Sprycel cessation is that all 3 patients had failed! N+ n1 m2 r* Q
Gleevec and Sprycel was their second TKI so they had resistant disease. This is, d1 J0 }% ^2 _- ]
different from the stopping Gleevec trial in France which only targets patients
# D- g( P% @/ O( F8 Lwho have done well on Gleevec.2 d5 M {9 v* B7 x5 j2 x
; V8 e7 k0 g5 ?7 D) CHopefully, the doctors will report on a larger study and long-term to see if the
9 \$ S2 e3 r. ~/ s! j1 d0 presponse off Sprycel is sustained.5 S! E! V: i' B3 O6 O; c6 u0 A
, E% g/ @/ }5 i1 }2 U# S& FBest Wishes,0 e0 [4 N; O3 K& }. w6 Y
Anjana
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- _( z/ |/ K3 m6 y$ N) {3 ^/ X2 e, k, Y3 G- W9 [6 Y! {- r) \
Haematologica. 2011 Aug 9. [Epub ahead of print]
7 z1 T9 V+ O) c+ W3 o: o+ D0 HDurable complete molecular remission of chronic myeloid leukemia following
8 j$ V6 o( M% }# w/ M$ L0 m6 b1 gdasatinib cessation, despite adverse disease features.
0 `- d/ S! d* W8 y* R: @0 p6 i' s. J- @Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP. X3 n6 w2 c& _1 V, U/ [2 \$ L
Source
1 M* w9 S/ w P) {2 w# zAdelaide, Australia;
6 R- e6 B. q S; @, B: k4 [* Y; q9 R( [
Abstract
* Z; ~9 M( l7 N( l+ ~Patients with chronic myeloid leukemia, treated with imatinib, who have a% ^, {: l ]0 W) M: j
durable complete molecular response might remain in CMR after stopping
/ V: B0 u9 p! a* ^treatment. Previous reports of patients stopping treatment in complete molecular
}2 S# k* W: mresponse have included only patients with a good response to imatinib. We9 Q9 D' ^; I, o" b4 `( U& a
describe three patients with stable complete molecular response on dasatinib2 m; e6 n5 O2 }3 h
treatment following imatinib failure. Two of the three patients remain in% D5 f+ n( l$ I% V8 ~
complete molecular response more than 12 months after stopping dasatinib. In: W0 T# F% i ^4 D) h% Y
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
0 a1 h8 K: l- ~3 ]2 G* A# bshow that the leukemic clone remains detectable, as we have previously shown in7 k) P2 O$ r! r3 z
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as7 }" K( T8 @) R9 k' g! K: ^0 i
the emergence of clonal T cell populations, were observed both in one patient# y& P; S) q2 H
who relapsed and in one patient in remission. Our results suggest that the" P8 K% G9 q6 s# y) y$ D$ U
characteristics of complete molecular response on dasatinib treatment may be* \: b! y% r6 G+ R
similar to that achieved with imatinib, at least in patients with adverse
+ W/ N# f/ L) l, B. s( a7 t, z) Q9 ndisease features.
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显身卡
