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- P1 k5 X1 D5 v+ M' m6 m! E0 T 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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' t- y- O+ p, ]" Q作者：来自澳大利亚5 ]* X: Y6 D! a
来源：Haematologica. 2011.8.9.
$ x) Q9 j. X5 K( p% k1 UDear Group,
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1 U! K1 M( U1 o! zSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML3 P3 Y( B6 t( b) H7 l" l6 X
therapies. Here is a report from Australia on 3 patients who went off Sprycel" u, p$ s" F0 Z5 i) v; m
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients' F3 r0 R& m0 ?9 q) ]$ |
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel! l, r5 Y& {+ q' ~! N7 s! e1 Q
does spike up the immune system so I hope more reports come out on this issue.6 r y6 K$ v" m) d( ]+ O
m1 }7 e! o. Q* p jThe remarkable news about Sprycel cessation is that all 3 patients had failed- a, z# H. c0 F) S
Gleevec and Sprycel was their second TKI so they had resistant disease. This is$ a3 n) T% ?2 o* [% \
different from the stopping Gleevec trial in France which only targets patients' U6 d3 T) G7 `) g' y7 P- x
who have done well on Gleevec.2 H: x) T0 L& X/ p+ e& r
& f( m# Q4 v6 jHopefully, the doctors will report on a larger study and long-term to see if the4 N# X/ W) _$ B
response off Sprycel is sustained., ^% |0 I5 Z! ]# G9 }/ _3 @+ C
+ S6 M9 U1 [ N$ h0 bBest Wishes,
2 [ v1 A" {$ N- L) K: R% PAnjana2 `8 _! V9 u/ P* F0 `
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* c1 ]( u3 @2 ?( l+ k' A2 [Haematologica. 2011 Aug 9. [Epub ahead of print]
5 c# N6 R G+ Z4 MDurable complete molecular remission of chronic myeloid leukemia following4 U w. O: R* b, j8 P
dasatinib cessation, despite adverse disease features.
Q2 T& C* q. i! W- b k: lRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
6 v& u' o5 ^4 u& P, XSource& i$ D# f4 [5 @
Adelaide, Australia;
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Abstract
! I& d- m; @6 c0 N6 P" b1 MPatients with chronic myeloid leukemia, treated with imatinib, who have a9 J/ E+ Q( f1 n z3 Q
durable complete molecular response might remain in CMR after stopping0 o7 v. Z! \1 C U7 H: T2 ~1 U9 S
treatment. Previous reports of patients stopping treatment in complete molecular
, H N! U! ]0 @- Z* q4 w( c$ Sresponse have included only patients with a good response to imatinib. We/ A5 Q# l. J6 m. l) P0 q7 g) s
describe three patients with stable complete molecular response on dasatinib" L6 `6 A0 r6 k6 i! b5 r7 w5 B. }5 t
treatment following imatinib failure. Two of the three patients remain in
+ a# N, x( J0 Z: e* z( w8 ?6 @2 Ocomplete molecular response more than 12 months after stopping dasatinib. In2 p! N% ~; Z' a" d, D' X5 z
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to' L- p% a6 Z5 A0 d
show that the leukemic clone remains detectable, as we have previously shown in' S1 ?+ g: K+ f8 j7 m8 K# ~% x$ u) U, x
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
+ Y" t% E2 C8 H/ ?; L. D8 jthe emergence of clonal T cell populations, were observed both in one patient
, b. e! x3 |* |8 k2 w7 `. @* Dwho relapsed and in one patient in remission. Our results suggest that the
4 M2 {/ g- K3 m* C( ]0 M+ Mcharacteristics of complete molecular response on dasatinib treatment may be- h H) |; t1 D. g% [% V! u/ m
similar to that achieved with imatinib, at least in patients with adverse) F' g/ p4 S. J5 s3 z9 S, m
disease features.
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