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。; f1 [# ?, i8 m) j! \
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
$ t$ u- O1 D/ k( g' i& {5 P* j来源：Haematologica. 2011.8.9.' v5 {1 G# M# t9 R
Dear Group,
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6 d7 \6 g7 a0 A! d3 K3 b/ Z9 XSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
9 E& M, B3 c% K$ ]2 O4 n- _therapies. Here is a report from Australia on 3 patients who went off Sprycel8 }; m- e1 \" o6 | a. n
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
( e! D" J1 V6 C9 T+ C' l0 g6 c$ Kremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel' K( l. r* e- E3 i" @. c! U0 p3 A
does spike up the immune system so I hope more reports come out on this issue.: @% r6 ?# M, W G9 F& y/ ]# H
9 ]# B5 R6 n% W' c
The remarkable news about Sprycel cessation is that all 3 patients had failed" @2 M U# \9 d$ w! n
Gleevec and Sprycel was their second TKI so they had resistant disease. This is! k& c5 ^/ ]# j
different from the stopping Gleevec trial in France which only targets patients
u4 y4 x7 k; P% {* s9 b( Xwho have done well on Gleevec.1 a: ?, z( j% {, z, w% G9 \/ }2 i6 a* e
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Hopefully, the doctors will report on a larger study and long-term to see if the
; @4 E9 w8 d( B; J$ l7 tresponse off Sprycel is sustained.
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6 G8 [& i C) M: L1 I) jBest Wishes,
$ Q9 S( q9 j4 L: c; w) @Anjana" L0 l1 v6 k3 t
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6 @+ }# E1 I. b) A. t# x
* z3 E" a0 Y5 Z0 ^3 V4 M5 fHaematologica. 2011 Aug 9. [Epub ahead of print]
; ~; B7 N3 Y# _5 |$ T- e: u5 S, UDurable complete molecular remission of chronic myeloid leukemia following
6 O5 Y$ E0 x: [3 |, ^dasatinib cessation, despite adverse disease features.
D$ x9 d! m6 P" s* u- C" }% z* QRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.3 O/ u c: s* A" {+ c. |! Z. e, Y
Source' T& p J: V$ P4 ]& F Z
Adelaide, Australia;0 ^+ P2 j" @+ u4 e, B
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Abstract
! e( [2 H. j& j0 O4 fPatients with chronic myeloid leukemia, treated with imatinib, who have a
: J* b ]7 n' cdurable complete molecular response might remain in CMR after stopping6 H6 @* U; ` u7 }, A3 r5 n4 f
treatment. Previous reports of patients stopping treatment in complete molecular& O5 g- [; l) e6 s6 Y7 A( O# |/ m
response have included only patients with a good response to imatinib. We
$ f0 V4 @& F1 Y9 {. y; Y1 ldescribe three patients with stable complete molecular response on dasatinib7 _2 b# M$ N/ j. z2 ~6 O
treatment following imatinib failure. Two of the three patients remain in
% L4 G. Y# z( k7 g" e* r+ P2 ncomplete molecular response more than 12 months after stopping dasatinib. In0 z; Y! F7 M v
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
% q$ n1 Y8 d1 [6 @$ Zshow that the leukemic clone remains detectable, as we have previously shown in
# L/ W4 i- m, e# u9 jimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
; ~( n. H1 @( h0 j. ^+ Rthe emergence of clonal T cell populations, were observed both in one patient
: T+ d- A; _$ U: z( awho relapsed and in one patient in remission. Our results suggest that the( o0 G' @' ]4 H
characteristics of complete molecular response on dasatinib treatment may be0 Q7 A) z6 F0 Z4 G
similar to that achieved with imatinib, at least in patients with adverse. R( q) p5 z/ Y0 v* b1 l: o
disease features.
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