关于停药的相关内容

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。
    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.
Dear Group,

# p# Z+ t7 ]% P/ x" iSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. Here is a report from Australia on 3 patients who went off Sprycel
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.
" `) B4 e0 t. I: S
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
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.
9 V$ S) W) m! G8 q7 w
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.

Best Wishes,
  q5 |) _$ i- ~. J& x. G4 x$ wAnjana
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7 o& Q* x+ e) T, J9 E. e2 @
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Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
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;
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Abstract
# H4 Q1 i1 }; W# z  U' H% OPatients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
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
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
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 as
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.

摘要：（STIM试验为法国的格列卫停药试验。）这个研究中，患者先是取得了CMR（融合基因转阴），然后停用格列卫，而后复发。15名复发患者在重新服药后又一次取得了CMR，他们同意再次停药。
3 H# a$ e1 H6 V8 y    第一次CMR持续时间为31个月，然后患者停药，复发的中位时间为2.6个月，然后重新服用格列卫，中位时间5.3个月之后取得第二次CMR。保持第二次CMR中位时间19个月之后，患者同意再次停药，这次，15名患者中有5名在停药随访中位时间24个月后仍然保持了CMR，而10名患者在停药中位时间2月后第二次复发。
    请注意，这些患者都是在第一次CMR后停药然后又复发的患者。

5 Q" E" K, i0 a+ J4 `  s5 z作者：来自法国STIM试验
来源：EHA 2011.6.会议摘要

很不错的文章，看来马老师家有考虑停药的想法了啊！祝福！

期盼易或特也能停药，但现在觉得是一个梦想！

这个非常有意义的研究。能吃下来停会再吃，再停，那是天大的好事