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。# z; X$ k: ~' U( ~) ]6 g
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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" f' T' g) u0 t+ H% R+ {( q作者：来自澳大利亚
; k" b- }$ w. y3 O1 F5 K# U来源：Haematologica. 2011.8.9.5 k+ K+ t7 u- Q+ C+ O( O+ o4 o( ~1 p
Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML G5 B4 M; b0 m! a# h, D% W1 N; n
therapies. Here is a report from Australia on 3 patients who went off Sprycel- h! S# M) Y; R4 N/ S/ n" t
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients) W' N$ M1 B6 Z+ I
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
5 O+ d* U5 p3 N+ Tdoes spike up the immune system so I hope more reports come out on this issue.
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( q0 G. c8 {0 [! n9 \" Y3 TThe remarkable news about Sprycel cessation is that all 3 patients had failed! `# S& P0 m7 Y# W4 B l9 u2 k: |
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
7 r2 Z# t p4 Pdifferent from the stopping Gleevec trial in France which only targets patients4 B5 l0 L2 U! e. N
who have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the
! X5 Y- p6 T+ o. iresponse off Sprycel is sustained.2 X( N# p l% y7 E7 K8 Q0 w
2 e! }- R) a- G4 C8 C. \
Best Wishes,, {# ?5 i8 p: h) n
Anjana6 B- k- ^: N3 G9 W$ o! F8 @/ c/ `
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; u/ }% S% n* s( C- ~Haematologica. 2011 Aug 9. [Epub ahead of print]
1 d5 X r' e/ hDurable complete molecular remission of chronic myeloid leukemia following) t) _' }6 |' }2 G' R# b( P' _
dasatinib cessation, despite adverse disease features./ W: d' k- J. i% B3 A
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.' e4 M" i) T7 k# ?& ?
Source
( `2 q% u+ I4 ~- y; v+ R, ?Adelaide, Australia;
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8 D# A" m/ i8 ^Abstract7 O7 w! K7 m" z! N" m
Patients with chronic myeloid leukemia, treated with imatinib, who have a
7 ]& f2 u2 [ A! G8 wdurable complete molecular response might remain in CMR after stopping
8 D: n; C4 i" [5 r* G$ ]4 `4 ^$ @treatment. Previous reports of patients stopping treatment in complete molecular. l* B% P' R9 w$ [' Q% v- R
response have included only patients with a good response to imatinib. We4 F0 @& C5 a1 ~+ \" z `! @
describe three patients with stable complete molecular response on dasatinib2 N# O0 Z( z c* h
treatment following imatinib failure. Two of the three patients remain in
4 J' b8 G/ W# }7 b# T# pcomplete molecular response more than 12 months after stopping dasatinib. In7 X. U# }" {. s. S2 e2 Q1 o- T
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to( }2 g8 q; m2 m, {6 a# o, ^
show that the leukemic clone remains detectable, as we have previously shown in
) {; k1 ^" O4 g) d& A- X' bimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
& e, U- C% p8 s A# `0 Bthe emergence of clonal T cell populations, were observed both in one patient
0 _7 q7 i' Q9 p7 }& L, awho relapsed and in one patient in remission. Our results suggest that the
3 y4 l4 y. u$ ^) E* ^characteristics of complete molecular response on dasatinib treatment may be. }' Y& b P! \" N
similar to that achieved with imatinib, at least in patients with adverse: ], R2 M& m; v; e; u1 w2 _
disease features.
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