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。* Z# Z o$ I9 B% _+ r
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" V) ]; V& N1 _4 h5 }4 N, v
来源：Haematologica. 2011.8.9.
5 g. t( r) {8 o8 b0 [- jDear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML9 ~ C9 m! H" Q6 k- f
therapies. Here is a report from Australia on 3 patients who went off Sprycel
7 m( }& B0 F# X2 w! C8 \after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients! z- O6 m, \- R# T4 w2 d
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
' v$ }3 s9 |- Ndoes spike up the immune system so I hope more reports come out on this issue.
8 j# y% |" m/ A6 o! p3 `0 I7 v5 d! W- u0 T; E: T" @7 n1 }* T
The remarkable news about Sprycel cessation is that all 3 patients had failed k6 H i* g& n) z! B0 W
Gleevec and Sprycel was their second TKI so they had resistant disease. This is8 Y4 D; ~& v, H0 M' P3 T! n
different from the stopping Gleevec trial in France which only targets patients
' ?: m- O- p$ `$ }! w6 @who have done well on Gleevec.: M% f$ j4 {2 j7 [1 h
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Hopefully, the doctors will report on a larger study and long-term to see if the
/ N; v% w; _7 y2 qresponse off Sprycel is sustained.& |! C8 @# Y3 z/ L
+ w$ W% W4 ` U6 w
Best Wishes,9 P: Z0 r+ f9 L* p( ^ S: L
Anjana
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0 B: I$ \6 x+ H6 @' q+ R, {Haematologica. 2011 Aug 9. [Epub ahead of print]( Q' B+ H; l4 @; ]
Durable complete molecular remission of chronic myeloid leukemia following8 }) l9 | \4 C& T1 O6 Y/ i! h: b
dasatinib cessation, despite adverse disease features.
) B+ S: |$ S& G& T. aRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.2 b) O$ N- e" [4 ~# m9 F
Source3 v; a e2 I3 M, {, |' m, r# ?
Adelaide, Australia;
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Abstract* z0 k a7 R% H7 o
Patients with chronic myeloid leukemia, treated with imatinib, who have a3 t- J8 B+ w5 s( q
durable complete molecular response might remain in CMR after stopping
* y* g& Y. N% Wtreatment. Previous reports of patients stopping treatment in complete molecular
0 K8 A! ?& R6 {$ o0 x9 lresponse have included only patients with a good response to imatinib. We: I4 C* [7 S, }! }% [' [1 Z
describe three patients with stable complete molecular response on dasatinib
- c. r8 B! X+ htreatment following imatinib failure. Two of the three patients remain in8 b& M) q9 O3 u& \( V8 L
complete molecular response more than 12 months after stopping dasatinib. In
% p0 U- R X' `8 l. m6 x/ mthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to, p# _4 J! a( @. T& M
show that the leukemic clone remains detectable, as we have previously shown in
6 q# T. a! I5 X6 Y. W& ?6 aimatinib-treated patients. Dasatinib-associated immunological phenomena, such as6 ^0 L, x+ h! F, W+ p! T
the emergence of clonal T cell populations, were observed both in one patient
+ @2 D# p6 x1 {. gwho relapsed and in one patient in remission. Our results suggest that the
H( p4 t5 S: ^6 S! q, Wcharacteristics of complete molecular response on dasatinib treatment may be
8 j" ^6 \5 r1 f6 c9 [similar to that achieved with imatinib, at least in patients with adverse
4 `) y- e9 e7 z! W9 s/ E- L9 Cdisease features.
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显身卡
