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。9 i. x& q8 x$ F/ \6 ?$ J4 i
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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: d3 ]7 y0 L# U M8 s4 w作者:来自澳大利亚
+ t$ J/ ^: s/ h( y+ f' P0 \7 [9 e来源:Haematologica. 2011.8.9." ?) _2 n8 \- M+ S+ ]
Dear Group,7 k, t# H4 B9 Z$ e7 X
# p# Z+ t7 ]% P/ x" iSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML4 i, J) C5 @$ B% ^
therapies. Here is a report from Australia on 3 patients who went off Sprycel3 v& J4 ^7 B$ x2 n% z& ^
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
$ E1 H1 |2 K0 ^+ z; w& g* E$ u7 d+ `remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
* }3 P$ a6 m8 C7 m M. u }# Gdoes spike up the immune system so I hope more reports come out on this issue.
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The remarkable news about Sprycel cessation is that all 3 patients had failed
7 M, T3 T7 ]* |* Y1 w# wGleevec and Sprycel was their second TKI so they had resistant disease. This is' ]. N3 t3 X+ t- {1 T
different from the stopping Gleevec trial in France which only targets patients
" m$ R) a: X; R E' @- o# Jwho have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the
$ C+ f. X M# g: {. [# p+ Tresponse off Sprycel is sustained.+ w# s% b; H* n9 [& }! v
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Best Wishes,
q5 |) _$ i- ~. J& x. G4 x$ wAnjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]7 M; `' u% G! P. Q1 P
Durable complete molecular remission of chronic myeloid leukemia following# ]" K" j4 C& `4 }
dasatinib cessation, despite adverse disease features.9 Y( h+ `5 ?6 n# h m3 ^5 j) R; d# ~- b
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
0 m+ l8 J7 V- W, V. lSource
. o# w0 e9 q4 n+ I: m* d P. O1 d' YAdelaide, Australia;
E2 e5 [/ ^8 c6 h; I6 o( w( u! f3 q6 H+ V
Abstract
# H4 Q1 i1 }; W# z U' H% OPatients with chronic myeloid leukemia, treated with imatinib, who have a- m/ p4 R& G4 n# s# v
durable complete molecular response might remain in CMR after stopping/ T9 l* Y) ~, N1 F9 ^$ e6 Z0 k
treatment. Previous reports of patients stopping treatment in complete molecular8 W) L/ H3 H$ u$ Q; [
response have included only patients with a good response to imatinib. We
( ?, F9 L7 ?" P0 G) {3 Sdescribe three patients with stable complete molecular response on dasatinib
, H0 y9 G8 _. Z4 g x7 Gtreatment following imatinib failure. Two of the three patients remain in
f- K/ a( z, s( ucomplete molecular response more than 12 months after stopping dasatinib. In) ~7 u' H( E5 R- Y. B
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to" w7 D$ A3 p. _, {8 K* ^
show that the leukemic clone remains detectable, as we have previously shown in
" q) v8 }9 ]. p) K6 oimatinib-treated patients. Dasatinib-associated immunological phenomena, such as7 q) D5 i. L+ C+ P N, T: U$ `
the emergence of clonal T cell populations, were observed both in one patient
( x0 i4 X3 b3 M+ `who relapsed and in one patient in remission. Our results suggest that the
2 P9 B7 o8 O1 j; m) P4 y8 gcharacteristics of complete molecular response on dasatinib treatment may be
2 c- r6 E4 ?9 A& Psimilar to that achieved with imatinib, at least in patients with adverse
8 z B0 m! i- C5 @disease features.( m" A' v7 a4 x y! u" O& W0 |9 } z
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