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。
3 ^ F/ s7 A9 F8 \# [! |, X9 [ 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
8 E$ k$ v4 o9 n$ r) R) |来源:Haematologica. 2011.8.9.; i1 H1 I; U. [9 b9 w
Dear Group,1 g; D7 C7 a5 h5 D9 q9 V
5 L5 E; Q7 Q h1 GSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
0 s( X- Q6 P( f# ^+ xtherapies. Here is a report from Australia on 3 patients who went off Sprycel1 t0 A) p0 C: D
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
1 E+ k& j# G; S6 `: qremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel0 \" k+ K: I5 b$ r1 M
does spike up the immune system so I hope more reports come out on this issue.: ?# d* [! N, T" p% j E5 ?
q. Y! Q: {, T4 \
The remarkable news about Sprycel cessation is that all 3 patients had failed7 F+ \! L6 l, z( W
Gleevec and Sprycel was their second TKI so they had resistant disease. This is0 {3 M" p7 G% ]; t3 S: ]
different from the stopping Gleevec trial in France which only targets patients+ \5 H+ A2 z6 ?9 u
who have done well on Gleevec.
( @0 Q3 Q H, X' k3 S& k) t
# k& n3 a% A+ ~; g L3 `) J$ dHopefully, the doctors will report on a larger study and long-term to see if the' L! m0 `# W( w- S0 N
response off Sprycel is sustained.
( K2 W- o* b# g: i$ C: R K e& O" J& M% p t. \/ _' i
Best Wishes,6 R, X/ f9 `0 w/ Q& z5 M1 |
Anjana g7 f0 B$ q( B9 M9 m0 |. w) A
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Haematologica. 2011 Aug 9. [Epub ahead of print]# B- Q0 V- t) T# m
Durable complete molecular remission of chronic myeloid leukemia following; g2 k G5 n6 ]9 k Q6 V. C
dasatinib cessation, despite adverse disease features.
, l% U5 u. T* X- W. i, eRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
8 t" H, P& R6 V7 |) N! VSource4 a( G$ u& G. B7 g) Z6 l- w! a/ [
Adelaide, Australia;
+ P5 p+ O! {% K4 w R, i
& n4 G1 z+ a/ q4 [" a9 W6 Q1 YAbstract
0 C4 H* q, U8 b8 J1 I. ?3 nPatients with chronic myeloid leukemia, treated with imatinib, who have a
' }: R/ D5 h2 P8 X/ Wdurable complete molecular response might remain in CMR after stopping" c6 k! }: b# z' Y5 G
treatment. Previous reports of patients stopping treatment in complete molecular
" s& Y6 \' i; ^0 x; Z% dresponse have included only patients with a good response to imatinib. We4 R6 U+ U8 _, _5 c( c+ H; `
describe three patients with stable complete molecular response on dasatinib7 U% d) f; v, Y" N* y
treatment following imatinib failure. Two of the three patients remain in- @+ T6 |! a- `! B4 l% F8 M. R
complete molecular response more than 12 months after stopping dasatinib. In
5 O; T; V: a9 R2 zthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
3 h. p/ t2 T3 K0 A, L" I$ j/ Qshow that the leukemic clone remains detectable, as we have previously shown in
& F# Y; L E0 u) U* A, gimatinib-treated patients. Dasatinib-associated immunological phenomena, such as2 g6 {* m. i6 h: W8 y
the emergence of clonal T cell populations, were observed both in one patient5 _1 E5 {: o+ t4 ~
who relapsed and in one patient in remission. Our results suggest that the
7 h9 b; ]& ?0 L0 y# L; j+ gcharacteristics of complete molecular response on dasatinib treatment may be3 V' T* E T/ E! k4 `
similar to that achieved with imatinib, at least in patients with adverse" x9 B, X- y8 Q1 k
disease features.
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