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。
    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。

( ?  U- R* G& d/ @作者：来自澳大利亚
* i1 V4 x# S6 a% C: V) [; H0 s! Q" b+ g: `来源：Haematologica. 2011.8.9.
Dear Group,
: K0 P( h- ^, m7 T$ `8 L5 Q
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
# k$ F9 `5 I- Y: W. C" atherapies. Here is a report from Australia on 3 patients who went off Sprycel
$ U+ C$ b' a( c+ n' Q+ s* Dafter 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
does spike up the immune system so I hope more reports come out on this issue.
4 k' h8 D: E$ ?5 N/ r' o% D
6 {! F7 M- t- ~# V8 BThe 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
5 s) D& g( i+ p  q+ E! X( pdifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
( \  l  }$ X9 P: b* O* b8 M" g3 e
. W5 o3 o. q8 ^Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
& M& r6 S7 F0 X" T
; ~. D3 V0 ~1 l+ P9 \* ~. F& {Best Wishes,
5 E+ H, ^5 D/ wAnjana
7 i& |8 P& f7 S) |

1 X: p8 {3 T2 w/ C6 B/ D$ j, L7 {6 c4 [1 h
: W0 N  L# E$ h  t$ C; x) E' o8 \Haematologica. 2011 Aug 9. [Epub ahead of print]
6 l  N; [# g" U' S; K3 B6 WDurable complete molecular remission of chronic myeloid leukemia following
0 p* ?- a. K, N+ [$ U- Bdasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
Adelaide, Australia;
% x  _( ?8 P6 q2 J
Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
treatment. 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
4 D: N6 y/ z9 l" u/ Jtreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
show that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
* X$ A$ R! }: u4 Z5 {4 ~the emergence of clonal T cell populations, were observed both in one patient
  y) P  a8 c/ I" K9 W8 ywho relapsed and in one patient in remission. Our results suggest that the
+ }0 b' U8 {' ]characteristics of complete molecular response on dasatinib treatment may be
& r$ F, v2 M: y5 hsimilar to that achieved with imatinib, at least in patients with adverse
disease features.
  i" D! A/ }. Z. d

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。
) n7 |7 K( }: Q) G/ b3 @; Y    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。
2 X3 F% H9 B, z3 N% T* x    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。
8 d+ X1 D0 }8 w% W4 \! `
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