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。$ k$ N9 F+ c8 ^- w
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。- R/ ?0 W' l. a# v. q. C" R' y4 q
: n) r+ ^$ y; l$ l, _作者:来自澳大利亚& `+ J+ W- O, i8 o
来源:Haematologica. 2011.8.9.6 v% D; Y' M$ B: N7 p
Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
+ Q& J' {, D/ c) [# k1 X* `' V- vtherapies. Here is a report from Australia on 3 patients who went off Sprycel
$ G! m/ K4 _6 _; w* n& _+ K# nafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
& ]3 e" d- C3 ?9 _3 c% |; hremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel0 A+ V" f" n+ @
does spike up the immune system so I hope more reports come out on this issue.
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0 l6 e6 ^# W& Q X9 ^% Z! iThe remarkable news about Sprycel cessation is that all 3 patients had failed
2 m- q) j; T3 H* d2 p8 q9 j3 D# tGleevec and Sprycel was their second TKI so they had resistant disease. This is/ u3 r3 A' L& J* y+ ~6 P% b( c
different from the stopping Gleevec trial in France which only targets patients4 F/ k# K2 r# u9 F1 J" a7 [0 a
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
: Y9 D2 t5 ~3 b# t0 ^" g9 Iresponse off Sprycel is sustained.
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Best Wishes,
7 U7 }2 [' e n$ _/ \4 Z1 k8 F! oAnjana
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( }* q$ y6 Y* ?2 O! o {Haematologica. 2011 Aug 9. [Epub ahead of print]7 o( \# m' o5 r! {; I' q9 w
Durable complete molecular remission of chronic myeloid leukemia following4 t' G7 E- t) I2 n P/ v- w3 H
dasatinib cessation, despite adverse disease features.9 z: h: i( A6 k E* C- O
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.6 p' n) g+ G5 A0 Y
Source
% D# W$ X+ Q- P7 D4 |7 j: fAdelaide, Australia;
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Abstract" Y0 B0 g! Y( o. H6 l* M
Patients with chronic myeloid leukemia, treated with imatinib, who have a& G% W4 L8 R k" t
durable complete molecular response might remain in CMR after stopping, |! Q: l6 Z X
treatment. Previous reports of patients stopping treatment in complete molecular6 `3 w0 S0 |" u; V: ^
response have included only patients with a good response to imatinib. We
& b, W# D3 r* ~- Q1 Jdescribe three patients with stable complete molecular response on dasatinib
$ ^! K; W" C8 d# Btreatment following imatinib failure. Two of the three patients remain in
5 E; f3 g/ Q: [$ a1 b$ ?complete molecular response more than 12 months after stopping dasatinib. In9 @7 D2 } b# Q8 B# ^ i9 o
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to5 D- }% X9 Y5 D7 ]- X
show that the leukemic clone remains detectable, as we have previously shown in
; t( X; ~, P1 j$ i, G" y- Kimatinib-treated patients. Dasatinib-associated immunological phenomena, such as: E; X h& }# B/ m. X1 I0 ?
the emergence of clonal T cell populations, were observed both in one patient7 {1 a+ x1 v9 w U
who relapsed and in one patient in remission. Our results suggest that the; e! N" Z( k, ]8 j
characteristics of complete molecular response on dasatinib treatment may be$ }5 |5 L2 {/ p: z: i- T
similar to that achieved with imatinib, at least in patients with adverse
+ i2 j. ?" R3 Gdisease features.
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