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。
& @" ~7 h% W' h( h l 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
' a9 V; t+ h$ { {/ b来源：Haematologica. 2011.8.9.
5 b& @( E" a! v8 y2 }Dear Group,- F! c; I3 S+ u( c; j0 y1 d% u
) m% p& W: R8 k3 d @- @" E& h ISome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
/ O' ?0 X# C- Wtherapies. Here is a report from Australia on 3 patients who went off Sprycel2 n. H1 @ U0 C% V; k* ]
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
$ M1 r0 O7 G3 q h, R# iremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel5 N5 Q3 f) m w H9 d$ i
does spike up the immune system so I hope more reports come out on this issue.9 X2 T$ F) E m+ H* v: S: \; V4 Q
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The remarkable news about Sprycel cessation is that all 3 patients had failed
7 [) p' [5 Q3 i1 N0 T, [0 `Gleevec and Sprycel was their second TKI so they had resistant disease. This is
' x6 y! E7 z& e$ w* K) D+ Z E- Jdifferent from the stopping Gleevec trial in France which only targets patients5 t9 A4 u! C- U3 p0 T
who have done well on Gleevec.4 n; Z0 z. \; P! |/ j T
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Hopefully, the doctors will report on a larger study and long-term to see if the
5 F, y2 ?! l- B4 p" presponse off Sprycel is sustained.. r$ V: ?, }$ t
( Z% E6 t! F8 b# t+ B: s0 C9 \Best Wishes, Z9 Z. J% w8 O0 a, Z1 G5 H
Anjana& S* a6 L/ k3 U3 x: V" B$ ^
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Haematologica. 2011 Aug 9. [Epub ahead of print]' J- a/ D$ d& x$ D( a
Durable complete molecular remission of chronic myeloid leukemia following
* {9 e& {% N8 \- r6 j8 A( jdasatinib cessation, despite adverse disease features.
* }4 w7 N4 [7 @$ |) W& {' E* }Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.7 B( r6 G! }& ]3 \
Source2 m c. w- C( p& w1 c
Adelaide, Australia;
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; l3 ]7 b0 l, N# TAbstract
% P/ e, _& Q* M" F1 J' M7 f% SPatients with chronic myeloid leukemia, treated with imatinib, who have a' e- j9 }5 p8 x3 e
durable complete molecular response might remain in CMR after stopping! t, l$ ]- K( d" f3 K: L" K4 [
treatment. Previous reports of patients stopping treatment in complete molecular
) t/ \$ P+ X6 C# w+ mresponse have included only patients with a good response to imatinib. We8 B) J- g0 }4 }; ^
describe three patients with stable complete molecular response on dasatinib
; z @9 G. b0 \1 \6 Y, B) rtreatment following imatinib failure. Two of the three patients remain in
' X$ L' x- L, L4 W- Fcomplete molecular response more than 12 months after stopping dasatinib. In
, o- d ]3 g) G" z _' I" ~* R/ I9 jthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to! i9 ^6 e& I/ |, \
show that the leukemic clone remains detectable, as we have previously shown in+ F% O- ?: D& X N; n4 y
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as0 Q) D' r) O/ ]( u; C
the emergence of clonal T cell populations, were observed both in one patient
* s5 E/ l( x: ] C4 B5 h+ gwho relapsed and in one patient in remission. Our results suggest that the
4 j( [0 @7 X+ z( q" \- ncharacteristics of complete molecular response on dasatinib treatment may be" W8 E4 ~2 C2 n5 w. \4 u, p
similar to that achieved with imatinib, at least in patients with adverse( i* {+ j4 Y, l7 N* K( i
disease features.
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