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。) I ^* f% C) |: U+ O5 \
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。/ @9 V8 }$ @6 _1 a; M
/ c9 j z. B$ w/ s" L7 D' l/ O作者：来自澳大利亚
; n/ \+ m! u9 Z8 v' e来源：Haematologica. 2011.8.9.
" f, {# y* Z1 `& sDear Group,
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9 y% g( w; x1 {' a- l) ]6 _Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
( c+ d8 ], G) g* v4 n8 Etherapies. Here is a report from Australia on 3 patients who went off Sprycel% t0 G7 {1 O9 M: u
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients! ~- Y. f0 Y0 G
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
6 z" E5 O3 ]0 L9 r' z( R2 o. Fdoes spike up the immune system so I hope more reports come out on this issue.1 i0 x5 P2 M/ F, L+ z0 O3 C4 H
* A- o0 U( W9 E0 V4 GThe remarkable news about Sprycel cessation is that all 3 patients had failed
2 r4 V" O# c% T. EGleevec and Sprycel was their second TKI so they had resistant disease. This is
- v4 w2 z# Z9 Kdifferent from the stopping Gleevec trial in France which only targets patients
1 M, C$ Z& S* p% J0 M8 `' ywho have done well on Gleevec., f9 A+ b5 A) }& j- n
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Hopefully, the doctors will report on a larger study and long-term to see if the& d3 G$ x* ^, Y4 a1 o# t+ ]& y
response off Sprycel is sustained./ N$ u9 A/ j0 y( T0 B( i0 j" W
2 J! D& O! r0 t6 L" e# r' M iBest Wishes,+ H5 P( c; _9 Q, C# F8 K+ w
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
8 W6 S4 ?$ x) Q" ^4 B2 XDurable complete molecular remission of chronic myeloid leukemia following
, V) w1 F* P1 ^) H) E0 @dasatinib cessation, despite adverse disease features.
- Q2 v8 d8 i- Q. a3 b ]1 |- ]Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.' o; ]6 E4 V# t+ B f. F5 K* a
Source
3 d; G+ |- X$ h% c. _Adelaide, Australia;
( ~' U4 M2 [) K
/ G, S) T! n- T# g: A7 [; ?6 NAbstract
' t/ ~! L# A& A |) [5 x& @4 S i& S) APatients with chronic myeloid leukemia, treated with imatinib, who have a$ K1 T8 k# h) V% a: R6 z
durable complete molecular response might remain in CMR after stopping5 G9 [2 m, A8 P
treatment. Previous reports of patients stopping treatment in complete molecular
6 u& @) a4 S6 W G3 U' }" Zresponse have included only patients with a good response to imatinib. We
; H; s$ `1 X5 @* ]! I9 tdescribe three patients with stable complete molecular response on dasatinib
( I& |! b5 W9 w5 A i1 rtreatment following imatinib failure. Two of the three patients remain in5 F- u0 }( B9 {; q! s) B
complete molecular response more than 12 months after stopping dasatinib. In
' I/ y7 M X- m) rthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to' u! U [, C$ \
show that the leukemic clone remains detectable, as we have previously shown in
- E$ N" M+ J% l3 d* D7 Rimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
; l' Q- F5 z% G5 W/ uthe emergence of clonal T cell populations, were observed both in one patient& `: l2 u8 X3 f" A9 D/ [4 c* u9 ]; B; Y( v
who relapsed and in one patient in remission. Our results suggest that the! o3 i3 E& c1 ?" w# S2 H: a
characteristics of complete molecular response on dasatinib treatment may be/ C5 Y) f9 c" o# X
similar to that achieved with imatinib, at least in patients with adverse
" v( c) z0 g0 i' w7 H; [ Bdisease features.# N; M: F0 k: o1 \! Z8 l2 w1 E# K
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