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。' M+ f; S7 _ i: D
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。
D) f! w! v. ]$ j : l: _. {2 B+ C, R5 D2 V5 [
作者：来自澳大利亚
8 [3 i: B6 I/ _7 i( N# x; n v来源：Haematologica. 2011.8.9.7 K' o: k0 L$ V! |6 x0 k3 V+ L
Dear Group,
! m: z( f1 N5 h0 p- D8 i: C' X+ [! v2 E
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
5 j# |# Y2 t2 y n7 i- itherapies. Here is a report from Australia on 3 patients who went off Sprycel
" @' B* T7 M% m5 T$ W1 N7 K; v7 [after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
# u. P6 Y7 K" K3 N* p/ Nremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
% w# _' l5 r% h) J# [, r b( Adoes spike up the immune system so I hope more reports come out on this issue.( [) G7 i$ p, A3 ~6 {
& t8 d6 g1 v2 K6 T. eThe remarkable news about Sprycel cessation is that all 3 patients had failed5 C- i2 `# W% W) o
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
& b b, n6 h$ i) i$ h) B( e! wdifferent from the stopping Gleevec trial in France which only targets patients
% M& X- B: i- H3 y' C6 a p" d8 c9 nwho have done well on Gleevec.) C' d( y9 x/ L3 h' [; c& m
, _' e8 _/ O, V4 nHopefully, the doctors will report on a larger study and long-term to see if the/ n f5 O* H' ]. r* u) b
response off Sprycel is sustained.
3 _" X% O2 P, M% M+ C# q
3 W9 x/ n9 Y" I0 e, Y4 LBest Wishes,6 g9 u2 L9 T" F
Anjana
) G @4 M. S5 o# S. [ f8 D2 Y
0 S' K* Y) x% ]. j }$ C+ j. e# ~) b2 `* G! R7 R3 C; P( }
# z8 W; h4 S: A4 V! YHaematologica. 2011 Aug 9. [Epub ahead of print]
9 Z9 B* k8 ]" v4 M, \Durable complete molecular remission of chronic myeloid leukemia following
4 ~6 H# S& B+ c2 U; ^* Jdasatinib cessation, despite adverse disease features.: V# K1 T# | W) ~
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
$ z v* u( h4 XSource
; P- M; C( f. J3 c) _/ e5 fAdelaide, Australia;1 z' |/ F% n2 p7 Z# i8 _7 p* P6 x2 u
* q) A+ ] X& W8 l* p
Abstract& V7 y' r# {; L( H. H
Patients with chronic myeloid leukemia, treated with imatinib, who have a5 K. v M8 w0 o( F6 d, {# C
durable complete molecular response might remain in CMR after stopping* G4 G- B$ [) \
treatment. Previous reports of patients stopping treatment in complete molecular
" y2 P% H& n/ }" i! lresponse have included only patients with a good response to imatinib. We
6 L, F. N H; ?3 L; ^: l! ?describe three patients with stable complete molecular response on dasatinib
" y! _2 o9 o. }( Dtreatment following imatinib failure. Two of the three patients remain in) l9 `% K3 [' w% ^0 H* V" k
complete molecular response more than 12 months after stopping dasatinib. In* }# l8 F$ p$ [- c" R- Q) m# j$ \
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
. B2 b2 {& Q: L* ]& e0 lshow that the leukemic clone remains detectable, as we have previously shown in
8 J9 z$ J% ]. ~2 J5 timatinib-treated patients. Dasatinib-associated immunological phenomena, such as" {! o" _9 ]' P5 A8 |
the emergence of clonal T cell populations, were observed both in one patient. b- s6 i5 K Y9 z `- i" h
who relapsed and in one patient in remission. Our results suggest that the% P; A7 l- o- A6 Y/ R& z- [* l! U+ v
characteristics of complete molecular response on dasatinib treatment may be$ v$ E2 T, F) b4 n, t2 ~; V2 M" K
similar to that achieved with imatinib, at least in patients with adverse
1 C! a8 y; l; {disease features.
( A F" V5 {) p9 n; M) E" ~ |
显身卡
