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。: B7 ]1 v4 Y: }! W
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, Q: j K0 Z3 |8 L) m$ ~3 `
来源:Haematologica. 2011.8.9.
( l u. R: _( V- q/ }6 }: _Dear Group,
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+ s2 U& S5 v& OSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
3 A, S4 @- O" m# x/ L0 Etherapies. Here is a report from Australia on 3 patients who went off Sprycel3 I- T; R' f' N* Y6 V
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
1 |/ A1 r1 @: g, v4 J/ wremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel0 d7 r1 M1 A7 O1 S+ H! B' N
does spike up the immune system so I hope more reports come out on this issue.* Z, I- R9 O f) G0 T* w7 f$ N
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The remarkable news about Sprycel cessation is that all 3 patients had failed
- n: A! v( ~: P3 }' x5 }" W- T+ j9 n- SGleevec and Sprycel was their second TKI so they had resistant disease. This is. R, @, j. h6 h
different from the stopping Gleevec trial in France which only targets patients5 u7 i* Z4 d3 @
who have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the
1 h7 z x# }7 M* P3 S& s rresponse off Sprycel is sustained.$ E0 K' K# k3 q# \& }0 L5 v
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Best Wishes,
, h. I) b( I$ }" d' ~4 \: s/ o5 sAnjana3 w9 k. J- g' J. C
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- @; m/ x0 d6 M( x4 ?" x* Y/ XHaematologica. 2011 Aug 9. [Epub ahead of print]0 M0 v: {; r, d$ v
Durable complete molecular remission of chronic myeloid leukemia following
1 d' n% q5 X! ~% }* k6 Vdasatinib cessation, despite adverse disease features." p1 Y% i$ H- ^7 ?
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
U0 n1 i8 I+ ESource/ B y& O* F* H4 r# F4 h( l
Adelaide, Australia;
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Abstract3 J. G1 {# s& H- Z3 Y
Patients with chronic myeloid leukemia, treated with imatinib, who have a
5 x0 ^$ Z% i! Cdurable complete molecular response might remain in CMR after stopping' @# Y. f- `; S+ g3 a- u0 h
treatment. Previous reports of patients stopping treatment in complete molecular
) T7 {) S5 Y/ {1 I5 N x1 n* Lresponse have included only patients with a good response to imatinib. We) s( Q7 K6 s6 ^
describe three patients with stable complete molecular response on dasatinib
! T0 p) `( @3 s0 {/ ^4 Ttreatment following imatinib failure. Two of the three patients remain in* i- q2 K2 h& p& | k' E$ I
complete molecular response more than 12 months after stopping dasatinib. In
/ A0 T' H% d3 wthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to a9 K. ~( l, F9 n% l) n7 D: t( P
show that the leukemic clone remains detectable, as we have previously shown in
, V" i- }- R' e |8 P1 S/ L% aimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
: d( M' I' U2 |3 Y {the emergence of clonal T cell populations, were observed both in one patient+ g( m; E& |3 V: q0 l2 R
who relapsed and in one patient in remission. Our results suggest that the
5 M! y* ~9 z) g, Pcharacteristics of complete molecular response on dasatinib treatment may be2 F E- ?) e1 z
similar to that achieved with imatinib, at least in patients with adverse- K7 O. `" c* X
disease features.
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