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。4 R) E+ H& N* B
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。- k" m* W, x& n/ R
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作者:来自澳大利亚
4 Z e- g! q" v! @来源:Haematologica. 2011.8.9.
! S5 m% ^0 H1 C7 q tDear Group,+ H# v* m# ?6 r$ Y" ?
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML4 a' u6 g$ m# q' d+ M7 r
therapies. Here is a report from Australia on 3 patients who went off Sprycel( h+ ~* u. Z& c' j5 R; A3 j
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients3 K) O; T S3 O1 Q( U
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel- Z- h1 S) Q! |, ~5 a
does spike up the immune system so I hope more reports come out on this issue.0 u6 q% H5 ~$ z, m% a2 o
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The remarkable news about Sprycel cessation is that all 3 patients had failed3 |8 y6 b" V4 T/ k; R9 @6 f
Gleevec and Sprycel was their second TKI so they had resistant disease. This is; T" V, p* g3 C2 h, s
different from the stopping Gleevec trial in France which only targets patients
( Q& f0 P3 F2 q7 u( A! {who have done well on Gleevec.: t9 [8 v% @, ?5 o# Z
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Hopefully, the doctors will report on a larger study and long-term to see if the9 }; N; N Q( c2 N
response off Sprycel is sustained.$ z& i, w# h* {. T
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Best Wishes,* r2 B2 N2 |3 F% b
Anjana0 M( C5 W$ g, Y' S3 O
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Haematologica. 2011 Aug 9. [Epub ahead of print]
3 E8 r0 D. K8 LDurable complete molecular remission of chronic myeloid leukemia following7 h$ M: a5 f: P" N5 D9 L8 U) R
dasatinib cessation, despite adverse disease features.3 _$ m$ ?& j a4 m; l/ L0 k6 ^
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.& ^2 b8 x# r# y2 F. K. N
Source
* Y1 Y2 N; U' O: }Adelaide, Australia;
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6 {1 M4 k" K$ v( A* h# h2 MAbstract
# `5 L9 V! X6 y% e; lPatients with chronic myeloid leukemia, treated with imatinib, who have a
3 P2 o3 R+ l5 u# @2 Wdurable complete molecular response might remain in CMR after stopping- r/ P) `* c- u4 k' }, @
treatment. Previous reports of patients stopping treatment in complete molecular
% R- I% Z f% c" N2 dresponse have included only patients with a good response to imatinib. We& m) u# u3 W( Q3 R/ O0 o U
describe three patients with stable complete molecular response on dasatinib
* S+ g& y8 K8 N' v6 o$ m% W' J. _treatment following imatinib failure. Two of the three patients remain in
& q7 Y3 O8 @. V' qcomplete molecular response more than 12 months after stopping dasatinib. In
" d: v7 Q% N9 q8 ^; Ithese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to3 K; I, Q- z' I6 s. J8 c
show that the leukemic clone remains detectable, as we have previously shown in) T; t0 L- n3 G! v; F6 A
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as- Q$ v1 ]- U. a) e6 w' g
the emergence of clonal T cell populations, were observed both in one patient
T% |3 W( {$ }3 Wwho relapsed and in one patient in remission. Our results suggest that the) u2 |$ o- o9 B5 \) P
characteristics of complete molecular response on dasatinib treatment may be3 J0 D/ }0 n9 w$ }" b' H
similar to that achieved with imatinib, at least in patients with adverse
3 t: E: C( P; J" a# Xdisease features.
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