关于停药的相关内容

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。
8 Z: D9 y, v4 V! e2 e    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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8 \! T1 s5 q) P- X8 P# \作者：来自澳大利亚
$ d& Y% e: |& p$ i: `9 z, c% p来源：Haematologica. 2011.8.9.
Dear Group,

! Y2 S+ C( `5 t) O* \5 fSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
$ G8 g8 U3 J# y* A4 `- Etherapies. Here is a report from Australia on 3 patients who went off Sprycel
5 S4 H3 W& O5 p" ~$ Rafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
2 m' l( r3 q6 m4 a8 w, Z0 ?6 tdoes spike up the immune system so I hope more reports come out on this issue.
3 D7 ^2 @) X. P. y' U- h0 W
The remarkable news about Sprycel cessation is that all 3 patients had failed
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
different from the stopping Gleevec trial in France which only targets patients
2 M* d9 r* {; `5 R! G* J! Owho have done well on Gleevec.

: x9 _- W# P$ q" mHopefully, the doctors will report on a larger study and long-term to see if the
% }- [- E/ M6 c7 A& }5 C" V3 g- ?response off Sprycel is sustained.
  G3 C1 @& _) K5 l6 K  o1 A
* }7 i) k' {! IBest Wishes,
0 c5 t& ]+ l4 C6 E: ^9 J, o' a; nAnjana
0 q6 t1 X9 O' a( _: J! p* k7 ^
5 C* g, s' E2 e  a% I

# g! M$ [) L5 x8 _+ gHaematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
8 k$ J% u/ [+ e+ D3 Edasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
$ ]% N. K; ]0 OAdelaide, Australia;
; T9 Z; k9 P1 x- I8 t% U$ _
Abstract
  s+ Y# O7 R! `  h, bPatients with chronic myeloid leukemia, treated with imatinib, who have a
: b  T. F' V0 b* W+ @0 adurable complete molecular response might remain in CMR after stopping
8 F% }* o5 w  ltreatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
8 Z4 F$ x( E: I" ?' F: Dtreatment following imatinib failure. Two of the three patients remain in
! o% e# x! H; y" _, d5 rcomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
" x4 d+ H3 A! K- L/ Oshow that the leukemic clone remains detectable, as we have previously shown in
0 G0 k) q% j: D: C$ d6 i5 iimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
) w( N6 s, J$ Y; Xthe emergence of clonal T cell populations, were observed both in one patient
* F: Q/ U3 ?# Q4 b! ?5 o* ^who relapsed and in one patient in remission. Our results suggest that the
# a- A  t) w7 T8 d. x0 f7 D% Acharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
disease features.

摘要：（STIM试验为法国的格列卫停药试验。）这个研究中，患者先是取得了CMR（融合基因转阴），然后停用格列卫，而后复发。15名复发患者在重新服药后又一次取得了CMR，他们同意再次停药。
* d4 }* \3 y' U8 |' k; [# c2 l! G    第一次CMR持续时间为31个月，然后患者停药，复发的中位时间为2.6个月，然后重新服用格列卫，中位时间5.3个月之后取得第二次CMR。保持第二次CMR中位时间19个月之后，患者同意再次停药，这次，15名患者中有5名在停药随访中位时间24个月后仍然保持了CMR，而10名患者在停药中位时间2月后第二次复发。
  H) u4 {9 i* t! l- ?- m    请注意，这些患者都是在第一次CMR后停药然后又复发的患者。

作者：来自法国STIM试验
来源：EHA 2011.6.会议摘要

很不错的文章，看来马老师家有考虑停药的想法了啊！祝福！

期盼易或特也能停药，但现在觉得是一个梦想！

这个非常有意义的研究。能吃下来停会再吃，再停，那是天大的好事