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。/ D2 B) a. s" Y% |5 {7 |
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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! s, v- i$ Y: R作者：来自澳大利亚3 S, |' S' i, F! p" E# l/ g+ @
来源：Haematologica. 2011.8.9.; b* q- e7 o- n+ Z7 a
Dear Group,3 J, r8 z! I! h
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
/ G8 q* N( @: _therapies. Here is a report from Australia on 3 patients who went off Sprycel0 z) ]8 |7 L5 K* O1 ]
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
) m% O1 ~' S: T) K% ~1 N4 oremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel" w% V9 H; T# m( b& U1 j7 d! v
does spike up the immune system so I hope more reports come out on this issue.
" X; x7 e1 s5 ?1 P7 E
" K( _6 A) ~4 @+ t( x7 {5 wThe remarkable news about Sprycel cessation is that all 3 patients had failed
* `- u3 @3 M0 i; H& _9 P! OGleevec and Sprycel was their second TKI so they had resistant disease. This is
: I+ Y3 L2 {" J# }2 Udifferent from the stopping Gleevec trial in France which only targets patients
8 s4 S3 K) X$ V. O3 G, \) I3 Hwho have done well on Gleevec.
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+ |( g/ U; {* T7 c- @2 C0 R' K. PHopefully, the doctors will report on a larger study and long-term to see if the( n8 s: V( s: S8 D6 Y
response off Sprycel is sustained.6 [) T2 H/ o- g! D S
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Best Wishes,
6 F/ v9 @ E" \% [/ Z+ n( qAnjana
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0 z) \- H7 y/ \
v, C6 c4 J2 o6 THaematologica. 2011 Aug 9. [Epub ahead of print]
/ }' f7 o/ U7 T8 x4 \Durable complete molecular remission of chronic myeloid leukemia following3 i- o+ ]7 x( H7 r# G' k! d/ L
dasatinib cessation, despite adverse disease features.
% U) V+ Z m9 a$ C/ N6 WRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP./ M; n) d$ h- w! r; H& _& x4 J2 N
Source
: ^7 o& \# [4 T9 G$ jAdelaide, Australia;! B; ]$ K9 |5 Y! B7 h9 U- w- _9 `
" s( D3 H, @; `% q* ~Abstract
+ Q9 ^1 l- }) d3 U* T+ \( o& v, ePatients with chronic myeloid leukemia, treated with imatinib, who have a: Q2 L& Z- ]6 _' ~% i- \1 n
durable complete molecular response might remain in CMR after stopping$ s8 [/ D( a ?% x9 X
treatment. Previous reports of patients stopping treatment in complete molecular
) s7 L' H' Z4 oresponse have included only patients with a good response to imatinib. We
' g; y* C6 p3 b0 ~/ |describe three patients with stable complete molecular response on dasatinib
" j9 B8 @9 S, }! X' q, k" W4 Xtreatment following imatinib failure. Two of the three patients remain in! Y) g e0 c9 z2 z4 }2 h9 a8 ]
complete molecular response more than 12 months after stopping dasatinib. In
5 r; K8 `1 J7 m h5 F/ Ethese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
# @- t& @' q+ ^. x3 Lshow that the leukemic clone remains detectable, as we have previously shown in: u1 |9 R- y6 a+ u I& i0 V/ f
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as" }+ L1 ^2 m+ E
the emergence of clonal T cell populations, were observed both in one patient; N) S! n) m8 J2 S! Y" b. W
who relapsed and in one patient in remission. Our results suggest that the
1 x3 V/ i) b( Z; Q$ qcharacteristics of complete molecular response on dasatinib treatment may be: x/ G, p7 S5 Y" Q S
similar to that achieved with imatinib, at least in patients with adverse
: ?( O( Q8 P) r( r$ C* ?0 [6 {disease features.
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显身卡
