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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作者：来自澳大利亚
8 Z+ f5 U5 g/ _# h6 T) }. C+ F  M! q来源：Haematologica. 2011.8.9.
: i, C* X% I6 G+ o& C+ P! kDear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
; k" F2 o% s5 t( l# `0 X( ^3 ztherapies. Here is a report from Australia on 3 patients who went off Sprycel
* k5 O- t# z$ c9 U' \  M! X/ dafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
; Z, ~* `- e/ |does spike up the immune system so I hope more reports come out on this issue.
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* `2 Z' X0 N! d6 \3 k7 ^The remarkable news about Sprycel cessation is that all 3 patients had failed
/ u/ \" }6 v- K0 jGleevec and Sprycel was their second TKI so they had resistant disease. This is
6 p& l( `# a5 j7 X& L  |: b. O7 Sdifferent from the stopping Gleevec trial in France which only targets patients
9 z0 ~, P( \' {  U5 p9 U/ z# V- rwho have done well on Gleevec.

Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

. t2 q& P3 ?2 ^Best Wishes,
Anjana
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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.
Source
! Y% B: m: s( B  ~; kAdelaide, Australia;

5 Q( s' X. p) w6 @: h; J9 y6 FAbstract
6 U; j% \' l/ \' d6 ePatients with chronic myeloid leukemia, treated with imatinib, who have a
, p) R( p, n' W+ U3 V/ jdurable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
6 R( W. ^$ ^% K' }+ Rresponse have included only patients with a good response to imatinib. We
  P/ W4 o( Y; u# ^9 vdescribe three patients with stable complete molecular response on dasatinib
% o) N. J, S; G  V% ytreatment following imatinib failure. Two of the three patients remain in
$ C7 j  _7 e- X' h$ ~  _1 b% ?, F" R: rcomplete molecular response more than 12 months after stopping dasatinib. In
1 D6 r7 f4 C4 o; `9 @these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
, Q" \8 l, X( S6 M, f- u# Dshow that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
; x& s: f0 q" i" h0 B% @; x! E8 Othe emergence of clonal T cell populations, were observed both in one patient
who relapsed and in one patient in remission. Our results suggest that the
5 B0 ]6 N, @. e/ a8 C0 h2 `- a  {characteristics of complete molecular response on dasatinib treatment may be
5 v- P! @' ]+ d* W' G. g5 y# Csimilar to that achieved with imatinib, at least in patients with adverse
+ E$ o  ~7 T. c$ l0 ^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。
0 d- P) j) o* x" k) n; v    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。
# |% d' _& v  _" S3 P9 Q3 X7 `! F    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。
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; \8 f7 x: O1 z2 [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