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。
- P1 u A; m/ q3 q7 U: 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。
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作者:来自澳大利亚
/ i% ^# U# i! D/ M: R. @来源:Haematologica. 2011.8.9.
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML3 P! A8 s9 @3 O3 M8 Q) `( L8 c
therapies. Here is a report from Australia on 3 patients who went off Sprycel; \& e+ p/ r4 {
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients3 n G) v, C/ `6 ^/ I8 V/ h! }6 l
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel1 `! d, F5 P3 g4 L, _
does spike up the immune system so I hope more reports come out on this issue.
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) ~. j/ `' v! G; a# @" W2 wThe remarkable news about Sprycel cessation is that all 3 patients had failed
8 H9 k8 U) j+ [: \/ b! RGleevec and Sprycel was their second TKI so they had resistant disease. This is) q& s' e; I+ s: y
different from the stopping Gleevec trial in France which only targets patients
: C4 ?# o$ z9 V( p3 y0 Pwho have done well on Gleevec. Y9 z9 t9 x1 {
' p3 e& f( k" g+ A; d' I- s: P6 IHopefully, the doctors will report on a larger study and long-term to see if the
6 h/ U8 a l& B; T: o4 H! Lresponse off Sprycel is sustained.
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Best Wishes,% ]) Q% a+ q. Z
Anjana' Z4 @& E, Q( [
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Haematologica. 2011 Aug 9. [Epub ahead of print]
1 B3 v, Y' i- s, ?" n" [7 hDurable complete molecular remission of chronic myeloid leukemia following
5 w" H, N! i7 f3 ndasatinib cessation, despite adverse disease features.7 v9 i- l4 O, d4 K$ m' C1 |" u0 m
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.* H* W, a. `+ H: _6 H4 c
Source. z1 x) ~) g6 T$ t g8 ^
Adelaide, Australia;
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T7 V+ W6 H+ u HAbstract
9 \8 Q- c6 `6 Q7 }6 o- _* }* MPatients with chronic myeloid leukemia, treated with imatinib, who have a: r' u- ^: M7 E$ Q# s
durable complete molecular response might remain in CMR after stopping
$ V+ T% S! }9 C1 _treatment. Previous reports of patients stopping treatment in complete molecular
9 r/ B7 k) r& _ Sresponse have included only patients with a good response to imatinib. We
% I. _5 p) Q" fdescribe three patients with stable complete molecular response on dasatinib% K/ G+ e2 s5 E4 V+ h
treatment following imatinib failure. Two of the three patients remain in
0 X. m* ]7 e/ ]8 T- |% A Icomplete molecular response more than 12 months after stopping dasatinib. In
9 o- _% e! r; I! V0 sthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
. x/ q# [/ e1 n5 w, E9 ^show that the leukemic clone remains detectable, as we have previously shown in% n/ n: v H$ h' I+ C6 p
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
- {2 R p; Z1 _ k/ h e4 Hthe emergence of clonal T cell populations, were observed both in one patient
3 f0 L; c Z: V8 V- b/ ^" M7 nwho relapsed and in one patient in remission. Our results suggest that the3 Y; u7 z1 w% B
characteristics of complete molecular response on dasatinib treatment may be/ _3 {2 M- J7 C9 V$ \
similar to that achieved with imatinib, at least in patients with adverse" r: T# h0 T; e' c. `
disease features.
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