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。
) h) d& h# S! Y/ t1 B9 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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作者：来自澳大利亚 m$ ~7 ]8 y9 ^9 x$ n
来源：Haematologica. 2011.8.9.
$ i y6 a) B" x4 G, gDear Group, O8 N$ h2 \8 V
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
+ a' J1 G( t. @- Wtherapies. Here is a report from Australia on 3 patients who went off Sprycel7 t& u( O. j2 x& [- Z M, A
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients1 r, i' V1 \) z! ^0 e8 l/ R
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
' h% |2 S) e: l ~- L! gdoes spike up the immune system so I hope more reports come out on this issue.4 ^& s# o; r' X; I
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The remarkable news about Sprycel cessation is that all 3 patients had failed
. x9 z5 i; n& w2 t4 V1 j0 RGleevec and Sprycel was their second TKI so they had resistant disease. This is4 F; d& H$ c- c4 D6 O5 o* u
different from the stopping Gleevec trial in France which only targets patients
+ R/ l, k# F+ m% ?( ]$ o5 {who have done well on Gleevec.% x: T! y+ |# f# \* U; [
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Hopefully, the doctors will report on a larger study and long-term to see if the' {0 D/ u' K9 U0 R! P' I9 t
response off Sprycel is sustained.
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Best Wishes,7 e- ~4 q! r) h& p
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
" h/ c' |8 E( iDurable complete molecular remission of chronic myeloid leukemia following1 N+ ^, s' S8 \+ e! r! ]# `2 K
dasatinib cessation, despite adverse disease features.
: I/ K1 V' j/ GRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.* l2 q; J$ s9 G6 m9 Y$ E! N
Source, [1 A$ `$ q" n
Adelaide, Australia;% Q9 P8 V5 _' Y* g- D5 q4 ^
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Abstract
' E& | u0 {: v: k$ c; WPatients with chronic myeloid leukemia, treated with imatinib, who have a5 N) W; q. c& b+ C3 Y/ k3 j3 |
durable complete molecular response might remain in CMR after stopping% v) z4 D$ T) |
treatment. Previous reports of patients stopping treatment in complete molecular
4 T& G+ J0 s$ O/ ]& R1 t# l8 ]+ N1 ]8 |response have included only patients with a good response to imatinib. We
3 F0 `; G# [/ {1 Jdescribe three patients with stable complete molecular response on dasatinib/ @# i8 \2 ^1 F9 d
treatment following imatinib failure. Two of the three patients remain in6 Y( T# ^7 z, ~* e& ~, X
complete molecular response more than 12 months after stopping dasatinib. In8 s1 O" m* Q. T7 f
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
( {; @2 b( h5 l2 g* i) pshow that the leukemic clone remains detectable, as we have previously shown in' U# K) O& r/ y$ J( r( p( C
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
. Z) o5 S' Y6 F8 H, wthe emergence of clonal T cell populations, were observed both in one patient
, P0 |) `# ~/ bwho relapsed and in one patient in remission. Our results suggest that the
$ P/ c2 \$ f+ q8 r# M; Acharacteristics of complete molecular response on dasatinib treatment may be: O( s! i3 c0 ^1 j% e: q' o
similar to that achieved with imatinib, at least in patients with adverse
2 r+ H/ s$ U- D4 }3 ?disease features.
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