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。
6 z" t3 e) n, j% ^# `    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
4 f( m5 _& H* l来源：Haematologica. 2011.8.9.
$ ]/ n, c  ]) q* \/ [- WDear Group,
( {& b3 K3 Q2 u/ k* e6 A8 J
8 m7 y( g+ i" ?Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. 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
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.

The remarkable news about Sprycel cessation is that all 3 patients had failed
$ q% i9 m- [+ Q3 qGleevec and Sprycel was their second TKI so they had resistant disease. This is
! _6 @7 Q  J" udifferent from the stopping Gleevec trial in France which only targets patients
1 P# {4 S6 p3 f& y6 _5 mwho have done well on Gleevec.
7 [2 x3 T# z3 o2 R- S
Hopefully, the doctors will report on a larger study and long-term to see if the
5 g/ R, w9 E- K6 [; tresponse off Sprycel is sustained.

Best Wishes,
; \0 V9 E, x. IAnjana

) z) s7 k7 }. V7 c8 s; R  T! E
4 [! @' l0 N+ S' v$ V8 s
Haematologica. 2011 Aug 9. [Epub ahead of print]
; D/ I4 r* F2 _: e# V& lDurable complete molecular remission of chronic myeloid leukemia following
. C% ~8 P. O/ tdasatinib cessation, despite adverse disease features.
4 P& {& q2 f% D8 i( m0 qRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
. q6 p: ]' R# ?5 A4 a3 _4 }5 i/ {2 ?/ KSource
Adelaide, Australia;
, u: w1 B- d8 P$ P4 [5 C; {
Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
' I. f3 Q/ H, ^durable complete molecular response might remain in CMR after stopping
* T- {2 U6 ?. M+ \& btreatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
! h! _0 N( V4 Jdescribe three patients with stable complete molecular response on dasatinib
( U: u+ F/ I' N, }# F/ @, ~treatment following imatinib failure. Two of the three patients remain in
+ b) z, _+ F1 S0 `/ E+ Vcomplete 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
the emergence of clonal T cell populations, were observed both in one patient
who relapsed and in one patient in remission. Our results suggest that the
) A5 P( O# T( ]! @8 x  jcharacteristics of complete molecular response on dasatinib treatment may be
( x$ k. T* }& p' d! C/ Q# {' esimilar to that achieved with imatinib, at least in patients with adverse
6 m2 F: ]2 C$ z6 [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。
    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。
    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。
2 g% Y- C0 [8 k+ q
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