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。
& g( A! |; y4 }    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。

作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
+ o3 s! o# C7 g& k& z2 CDear Group,
7 s: P: I8 `" @. j8 X
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
. W/ T6 m9 C3 \% _1 l; B8 ftherapies. Here is a report from Australia on 3 patients who went off Sprycel
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
4 g1 ~9 |. w$ N+ r3 U5 s+ A$ ]remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
9 f+ `  X+ }# s3 Q. ddoes spike up the immune system so I hope more reports come out on this issue.

1 c: K" N, t# Q2 [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
4 L/ B0 E- ]3 d: u* O) @$ F9 P2 zdifferent from the stopping Gleevec trial in France which only targets patients
5 g8 G' e* N; W3 |! q) ^+ |& V) D0 Kwho have done well on Gleevec.
2 F- M* Y+ M: e. K+ N  b* ^* B! b
Hopefully, the doctors will report on a larger study and long-term to see if the
% |$ C% r& c* @$ l% Vresponse off Sprycel is sustained.

* W* q  ~/ n( x+ PBest Wishes,
Anjana



/ r, f8 n* o. h  p+ f+ s6 p. f4 t1 \Haematologica. 2011 Aug 9. [Epub ahead of print]
8 ^" O- H- W" ?; z* l( yDurable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
Adelaide, Australia;
3 k- C! Q3 ?# H* N9 G- J
Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
! E) W! c& _: Ltreatment. Previous reports of patients stopping treatment in complete molecular
8 e2 ?# o2 p6 uresponse have included only patients with a good response to imatinib. We
6 A& `9 |5 v  @- _: I. I, Ddescribe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
: X& p) T8 t' m6 Qcomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
4 V6 D$ l' D4 y9 p7 Jshow that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
4 p" o2 J" T7 @( M1 K$ rwho relapsed and in one patient in remission. Our results suggest that the
characteristics of complete molecular response on dasatinib treatment may be
( N) r0 [( y  c0 [3 ]3 Gsimilar to that achieved with imatinib, at least in patients with adverse
disease features.
4 e- Y7 p/ V5 R- i- Y% X9 ]

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。
7 I/ _5 V  k" Q' Y+ x    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。
  c* }9 S$ ]1 D8 P3 c9 p4 _- s    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。

) |$ @$ A3 v- a; T作者：来自法国STIM试验
. [5 [% x; ]& d$ i: {" D& P. F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