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。7 d8 j$ o5 j+ u- ^0 z
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5 ~, y9 r7 q% X4 A$ r8 z
来源：Haematologica. 2011.8.9.0 O% {! i) H1 k! g, _! i
Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML& u* I7 x* V* L$ Z4 E* Z) G
therapies. Here is a report from Australia on 3 patients who went off Sprycel
; g- ?3 x7 _1 l* B) ^) lafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
( p' S! a8 z; W+ a, [* c- Premain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel ?: \$ o2 ~8 } S5 L1 o3 t
does spike up the immune system so I hope more reports come out on this issue.
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- Z$ |0 v! M( @: c: [6 XThe remarkable news about Sprycel cessation is that all 3 patients had failed
$ f9 i+ {5 C; QGleevec and Sprycel was their second TKI so they had resistant disease. This is# ?6 N' n( C9 C1 H4 j' l
different from the stopping Gleevec trial in France which only targets patients) Y5 b" |. ]& R' J7 U+ y4 t/ i+ C( n
who have done well on Gleevec.
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3 h+ A) E' S7 z D; A+ Z: }- ^; ZHopefully, the doctors will report on a larger study and long-term to see if the$ [ s2 J' H% T9 d' p( K
response off Sprycel is sustained.
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& x( a% s) V! W. zBest Wishes,+ n5 {- c6 O, t C1 ?+ C
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
* f+ T- j+ `9 V: H! ]+ N* V: sDurable complete molecular remission of chronic myeloid leukemia following$ V% i( Y" `+ E n7 D" Z; Y) m
dasatinib cessation, despite adverse disease features.) v1 T" B) s* B' O+ n
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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Adelaide, Australia;
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: i, `: `4 B, |9 SAbstract
9 L8 n8 ^- R; |7 K) e! ^Patients with chronic myeloid leukemia, treated with imatinib, who have a) j5 M9 B t$ W; d9 L4 [. f
durable complete molecular response might remain in CMR after stopping
/ Q; S) B- R8 K" v+ c0 gtreatment. Previous reports of patients stopping treatment in complete molecular! Q* d% w4 n" P9 C. O" E4 L
response have included only patients with a good response to imatinib. We
+ \' o* \. ?" W4 p+ B% adescribe three patients with stable complete molecular response on dasatinib1 q% M( F) y% e: _& f
treatment following imatinib failure. Two of the three patients remain in
% C: k. {8 B( `) f2 c5 p% f+ |complete molecular response more than 12 months after stopping dasatinib. In
6 x( S6 ~' \3 \8 }these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
) ~5 ~; S8 R0 |! s- e1 x$ f7 Lshow that the leukemic clone remains detectable, as we have previously shown in7 t" G. I0 d% o% B& g! I
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as2 U4 C3 K: ]0 N* D& R" u' ~: q. |
the emergence of clonal T cell populations, were observed both in one patient
! V0 }3 m7 @" s6 hwho relapsed and in one patient in remission. Our results suggest that the
1 u6 e+ L$ A+ L$ o! Ucharacteristics of complete molecular response on dasatinib treatment may be
1 i- j4 Y- h% hsimilar to that achieved with imatinib, at least in patients with adverse/ o% N$ o5 G9 }# A$ ^: S: ?& `, R8 ~
disease features.
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显身卡
