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。5 e. V& A7 u) H6 k, H+ L) e
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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9 W3 O2 x W: U3 [+ ^- d作者:来自澳大利亚- w' a+ w S4 K9 ?7 T5 N
来源:Haematologica. 2011.8.9.
$ j3 m; m( A- c3 v o! y2 oDear Group,
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9 I) D, a: n$ z: z. BSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML! X' p1 I! A: S4 m: Y- J
therapies. Here is a report from Australia on 3 patients who went off Sprycel
$ a5 X6 u+ b W' i2 O: dafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients s- E, I0 n/ t4 J6 q
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel3 L! ?7 v) T- {1 Y7 n \
does spike up the immune system so I hope more reports come out on this issue.
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& M, k3 h! j" `8 I: |1 U/ PThe remarkable news about Sprycel cessation is that all 3 patients had failed
* \$ V0 f0 H9 m$ a/ bGleevec and Sprycel was their second TKI so they had resistant disease. This is
* W- l0 B3 O2 k! p# q7 l1 Odifferent from the stopping Gleevec trial in France which only targets patients) i9 V' T* ^. f$ H8 p# p, B& S
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 [; D# ~' _' [" T( L* M
response off Sprycel is sustained.
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( X6 q& f2 t8 {. H; ?8 _2 ZBest Wishes,
; m1 M8 ]+ E; g- ]/ B8 ]Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
! `" X7 y% K% |2 G+ PDurable complete molecular remission of chronic myeloid leukemia following+ w- j2 I1 z0 a9 W* c$ O: H! L
dasatinib cessation, despite adverse disease features.
2 _( r: r) s/ P& oRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.0 \. E( ^7 e+ ?& ?! e7 m' A4 J+ K
Source5 A9 X' E5 z/ U7 b+ ?5 O$ `+ Q
Adelaide, Australia;
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Patients with chronic myeloid leukemia, treated with imatinib, who have a7 |5 v( {3 v& I9 m9 @5 l
durable complete molecular response might remain in CMR after stopping
/ t8 F4 ?* t( J, }5 ~2 E. Gtreatment. Previous reports of patients stopping treatment in complete molecular
" Y. f* b/ `$ K2 ?6 U- e, uresponse have included only patients with a good response to imatinib. We
" p+ n3 h6 {1 I x {) ~describe three patients with stable complete molecular response on dasatinib
+ d h- e2 D, N* c$ ftreatment following imatinib failure. Two of the three patients remain in3 I3 h5 Y! ]1 C7 E* I
complete molecular response more than 12 months after stopping dasatinib. In. w6 X! O( o) f; k# O& k% _0 v
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to7 L/ f7 A- L* J( B2 f
show that the leukemic clone remains detectable, as we have previously shown in: o- M8 e( w7 P; Y
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
9 L& o7 l2 W ?9 i" @$ [' Q' bthe emergence of clonal T cell populations, were observed both in one patient
. m8 ?% }6 z7 z% w- |0 `who relapsed and in one patient in remission. Our results suggest that the" m. c# S1 |/ |0 B) A" ]
characteristics of complete molecular response on dasatinib treatment may be- z S% l& b4 m7 j3 I/ Z" t
similar to that achieved with imatinib, at least in patients with adverse+ F# M+ e- {4 \- q9 @
disease features.
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