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* x) ]+ w$ N% A4 M 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。5 V1 b& R" [' D1 s. U# Y
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作者：来自澳大利亚
4 p; G# H0 O+ _9 z7 Y0 a* t/ L/ V来源：Haematologica. 2011.8.9.& a/ M+ @& P& U9 m3 }( D/ o
Dear Group,
9 b) N$ S1 B" ^
# m0 M2 h6 }6 F; |, w# lSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML5 v" ]1 k! a: {( H- p+ Q; r, H2 T7 m
therapies. Here is a report from Australia on 3 patients who went off Sprycel0 w) J$ D$ }# B( {5 T' U' {
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients) F8 o, S# G' `) S1 U8 h
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel9 W7 K6 H; B6 A$ I! L( I
does spike up the immune system so I hope more reports come out on this issue.
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. ~' b' p% E# S3 m, |2 qThe remarkable news about Sprycel cessation is that all 3 patients had failed0 D, S2 ^5 S3 Q- k# Q# m
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
) v+ b# j9 g9 c. B/ P- c/ v( e: sdifferent from the stopping Gleevec trial in France which only targets patients
4 F5 x1 D; }" Lwho have done well on Gleevec. c% D$ K2 O* c% u7 u0 X
$ w$ B) j, B; b f* S7 }Hopefully, the doctors will report on a larger study and long-term to see if the& U9 `% }4 G- N$ Z; U& \
response off Sprycel is sustained.$ i6 [1 ]$ p5 V; P- a; i
. v) n& X7 W1 hBest Wishes,
, A) U9 c4 b+ ?9 W9 B+ E# EAnjana
F( o2 U& t* l$ P, s0 G
3 `$ i# ^" _9 u) M4 H
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) A8 L/ N9 ~, F. UHaematologica. 2011 Aug 9. [Epub ahead of print]
5 `5 W" _0 b4 y- l# H& W! b2 eDurable complete molecular remission of chronic myeloid leukemia following& M& A% o) a# N+ y0 T
dasatinib cessation, despite adverse disease features.
! n; ?! ^: l' S9 K; o8 ~- B4 XRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
2 `, W, X/ i6 T2 e) [: E- K# NSource
# n. Q& o, g) aAdelaide, Australia;
7 E% U2 \# I: d9 Y* D7 _3 z
/ b* l# ?/ G8 [$ M! K% Q6 VAbstract
9 [* z) l3 Z/ r5 r1 D- Q1 _/ bPatients with chronic myeloid leukemia, treated with imatinib, who have a5 D# w' t$ ~: d9 P
durable complete molecular response might remain in CMR after stopping
9 c9 q% [9 h* `treatment. Previous reports of patients stopping treatment in complete molecular" g+ ?4 l9 E+ D1 U2 R! i
response have included only patients with a good response to imatinib. We0 U! I9 c; E6 J# i) K
describe three patients with stable complete molecular response on dasatinib. r: b) ~0 f. @# x ^- A+ c, W
treatment following imatinib failure. Two of the three patients remain in, d9 ]+ z# ?4 n3 Z
complete molecular response more than 12 months after stopping dasatinib. In$ w2 P1 c: t' R1 v7 I1 v
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
* k6 ~0 L* \; V5 E! a/ h8 Ashow that the leukemic clone remains detectable, as we have previously shown in
: n- K+ v1 Z% H4 Y5 w# F6 dimatinib-treated patients. Dasatinib-associated immunological phenomena, such as' g/ ~& D% T+ H7 t
the emergence of clonal T cell populations, were observed both in one patient
; r: v2 D- l w6 \# a2 ~( qwho relapsed and in one patient in remission. Our results suggest that the
5 A4 k0 g7 W6 `' ~3 c* O0 o* f& wcharacteristics of complete molecular response on dasatinib treatment may be9 |( Z# l8 T# @* P% S
similar to that achieved with imatinib, at least in patients with adverse
8 Y% I: U- C2 G7 X4 S$ vdisease features./ l5 g- d4 j; u3 d+ ^
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