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。$ A4 x2 n# i- Y! W7 S! 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。
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作者:来自澳大利亚6 e7 o8 O( }( R, l. b- z" X- z" M
来源:Haematologica. 2011.8.9.
$ u. [5 R @+ f$ YDear Group,
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7 X2 Q& b( i, @3 x( e, E$ MSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
+ n: E8 Q" ^+ R) M1 K$ itherapies. Here is a report from Australia on 3 patients who went off Sprycel
5 e, f' F9 ^8 J* [7 `8 A) Tafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients' A" `& C% w/ \) g/ s
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel9 o) A. Q1 M% j6 H- G4 R
does 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
8 l w4 V }- y2 N6 J jGleevec and Sprycel was their second TKI so they had resistant disease. This is
9 g+ {; q( T+ U) Tdifferent from the stopping Gleevec trial in France which only targets patients8 X1 a# k z+ k6 E# L& o
who have done well on Gleevec." @' _! X* y" d7 \/ p
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Hopefully, the doctors will report on a larger study and long-term to see if the' ?, I0 r5 B0 F4 u; i
response off Sprycel is sustained.& }% v h) b, l/ W
5 @; t! t4 \, X9 F( e" k$ DBest Wishes,
/ P6 J/ S. T. Q# m1 \Anjana
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% z7 I. S* O5 }) H. B; vHaematologica. 2011 Aug 9. [Epub ahead of print]$ c- q6 {. ?+ b$ a! ]5 k
Durable complete molecular remission of chronic myeloid leukemia following
: h& t e# U' Sdasatinib cessation, despite adverse disease features.: m7 l" h( W, T' T
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
, A: j& S, V- q7 M2 `Source
P. w- ?2 R# C* n! g, sAdelaide, Australia;
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V2 _4 H# K* n6 c' t$ P3 _( VAbstract
, f5 l8 {2 A \/ d" h7 N6 D% cPatients with chronic myeloid leukemia, treated with imatinib, who have a% F% { @' o9 T: }
durable complete molecular response might remain in CMR after stopping2 [+ ]2 N/ q4 c9 Z1 T
treatment. Previous reports of patients stopping treatment in complete molecular
2 N4 y- \0 g4 [% d" nresponse have included only patients with a good response to imatinib. We
& Z% K, Z2 i# W, bdescribe three patients with stable complete molecular response on dasatinib) E9 L& }7 Y2 a, K6 b, ?( h
treatment following imatinib failure. Two of the three patients remain in% F) F' ]3 g e3 M1 e6 E
complete molecular response more than 12 months after stopping dasatinib. In: c2 s2 u' V. Z# q
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
p* z8 p1 c/ W, w; L3 [, Ashow that the leukemic clone remains detectable, as we have previously shown in
# h7 E$ q8 j. H: G; [imatinib-treated patients. Dasatinib-associated immunological phenomena, such as$ G* U5 B; a$ ~% O9 Q k' H3 n
the emergence of clonal T cell populations, were observed both in one patient
3 v5 P% I& V3 K5 H1 Awho relapsed and in one patient in remission. Our results suggest that the8 j6 M( I ?- B1 b2 S
characteristics of complete molecular response on dasatinib treatment may be' C0 }, k2 u0 \3 D6 \
similar to that achieved with imatinib, at least in patients with adverse1 m1 T) o5 |/ _. S
disease features.4 k2 s H7 E/ Z& b1 j
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