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。
: D6 c+ u5 D; J 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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6 T4 O& M+ K$ Y" w9 `作者：来自澳大利亚
% D# J; h+ Z9 j5 b" O来源：Haematologica. 2011.8.9.
- ? W9 r2 S/ B* hDear Group,
/ ~7 A' l+ k" j1 V. a: d& G
3 P9 n( c: s @' n tSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML( D) a/ P' N) R/ |1 c- m* J
therapies. Here is a report from Australia on 3 patients who went off Sprycel7 q! z: C3 d1 y5 K+ K7 N
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
$ c& i# ]5 V- [ ^$ Y8 P2 bremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel. }+ h7 p& B) |7 d9 q& I" P
does spike up the immune system so I hope more reports come out on this issue. U' d- q; j4 M
# K1 z6 \# h" \ T2 o1 o6 qThe remarkable news about Sprycel cessation is that all 3 patients had failed
3 E4 }8 ~$ c! f! e$ n' Y: Z* d+ ^+ HGleevec and Sprycel was their second TKI so they had resistant disease. This is
$ w/ e6 D' A4 g0 C/ u3 [different from the stopping Gleevec trial in France which only targets patients B% H- x: s6 i q; H! Y
who have done well on Gleevec.# v8 T2 l/ s- _3 ?1 r* K8 S& K
: B( B8 N: \$ X* gHopefully, the doctors will report on a larger study and long-term to see if the
8 X1 |7 }; _6 L- a- _4 qresponse off Sprycel is sustained.) W: G+ J5 t# m
7 Q' x4 g) h, L$ ^$ A$ J' W2 B
Best Wishes,
; Y/ n( t1 G4 Y0 I$ c% LAnjana
6 b6 S5 b7 B: @
n5 n2 F3 L, v7 k; ^- ]; Z# \3 t7 n
" d/ T) u5 t% w3 c- `Haematologica. 2011 Aug 9. [Epub ahead of print]
+ N1 W5 y4 {) }1 S# iDurable complete molecular remission of chronic myeloid leukemia following8 B$ ?8 T8 d3 F
dasatinib cessation, despite adverse disease features., p% B0 y# v, S
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP." ~5 v; C: S( P, Q+ p
Source; X3 m9 _6 n+ B& U7 G- H7 q w
Adelaide, Australia;/ X& M9 y4 J! ?
2 u* X8 m- o3 a( }/ m3 ?4 iAbstract
2 x4 u% w" h& H4 x$ \Patients with chronic myeloid leukemia, treated with imatinib, who have a
4 l* N/ I3 m, r5 Adurable complete molecular response might remain in CMR after stopping
7 J$ K& r0 y4 U$ I6 t8 ]: _4 S- Ptreatment. Previous reports of patients stopping treatment in complete molecular8 c7 } _' o( V% D: ^2 d
response have included only patients with a good response to imatinib. We4 D+ n9 s) W: G# Q. D( G
describe three patients with stable complete molecular response on dasatinib( d( G% l. {* E
treatment following imatinib failure. Two of the three patients remain in6 q/ l9 e! B2 W
complete molecular response more than 12 months after stopping dasatinib. In: ?4 s1 v3 s+ R+ r
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to9 \: t( O. R- e+ R+ A- j" J
show that the leukemic clone remains detectable, as we have previously shown in, G4 r6 t$ O2 _4 x8 X7 r
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as- ~* L3 D+ S. J# e9 f
the emergence of clonal T cell populations, were observed both in one patient( Y" z5 c+ \1 ~
who relapsed and in one patient in remission. Our results suggest that the4 h2 V! {& R, W- X! A5 m7 R3 s
characteristics of complete molecular response on dasatinib treatment may be
7 O( A G `7 L7 Xsimilar to that achieved with imatinib, at least in patients with adverse
9 u; N# C1 e' p9 c% jdisease features.! ^4 j. a5 j& e* B/ O
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