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。
1 `- ]" Q7 E( F& M1 G0 Y+ I$ P: ^3 p 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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' H9 k: o4 h0 v9 u. x3 Y% Q作者:来自澳大利亚3 g4 G( R, w( D5 f9 ^, `$ x
来源:Haematologica. 2011.8.9.
# K4 o5 M0 L0 P7 n/ dDear Group,; U/ d9 t2 d" n
& Y6 P4 R- Z1 E/ I/ J
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
, a1 I, _& c8 k$ t/ v: x3 _therapies. Here is a report from Australia on 3 patients who went off Sprycel
8 z' x! L8 e2 d7 e, ?7 f: W2 wafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients1 v, c3 M6 a& \
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel* B$ d6 ?: z) U; V" e
does spike up the immune system so I hope more reports come out on this issue.
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" `% U$ p: W( y# H" c& |The remarkable news about Sprycel cessation is that all 3 patients had failed) W$ f6 ` G1 p8 B$ Q* c3 g3 X8 I% [
Gleevec and Sprycel was their second TKI so they had resistant disease. This is0 n4 ]3 `3 x) J5 n4 U5 ^, ~" z
different from the stopping Gleevec trial in France which only targets patients
_, h7 ~5 V- @" v1 \" Qwho have done well on Gleevec.# g3 \0 M4 u5 S/ ]9 a0 E# a
: _. Z+ i0 |6 v4 W. a3 [7 ]/ t7 YHopefully, the doctors will report on a larger study and long-term to see if the; k' H5 q) a+ E# Z; L, ?/ @
response off Sprycel is sustained.3 c0 e! _2 u9 J! C& f
; {/ c: q% K1 o6 T# qBest Wishes,7 g% B# v3 M( B2 q
Anjana
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7 b) u. b2 T. q+ O3 V7 P# C/ _1 l. c/ M( J" ?
Haematologica. 2011 Aug 9. [Epub ahead of print] M5 }" q4 Z; g; ]( g
Durable complete molecular remission of chronic myeloid leukemia following
( c' \: K/ g0 R9 M4 J$ Ldasatinib cessation, despite adverse disease features.
1 o3 J+ `& d, m; `3 nRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.* T. J0 k n$ k3 q3 H( k
Source
4 [. r+ B% ^2 Z& F" GAdelaide, Australia;) v" E# f, k5 r/ f# h3 w9 ^) l) s
( o- b$ m! u# q! AAbstract8 j* w" c5 `0 k7 m
Patients with chronic myeloid leukemia, treated with imatinib, who have a% Y( K# b# j: f3 p0 K4 ]1 `/ u
durable complete molecular response might remain in CMR after stopping. U$ i, _0 t* x4 v3 J* K
treatment. Previous reports of patients stopping treatment in complete molecular5 I; ]! K7 |. M
response have included only patients with a good response to imatinib. We
/ U/ z6 U. N" K+ p# g, `: i. D! ndescribe three patients with stable complete molecular response on dasatinib- `! }4 p, W; g8 P8 w$ h
treatment following imatinib failure. Two of the three patients remain in- l2 H$ e" G; ^( z% h, Y
complete molecular response more than 12 months after stopping dasatinib. In
4 R" ]) k) O. x7 kthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
) n6 H% L0 l3 R- r- }- ]show that the leukemic clone remains detectable, as we have previously shown in6 K8 g% W6 j9 Y. p+ }3 t3 a
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as- l" a- Y* G9 X( i6 g6 J8 g
the emergence of clonal T cell populations, were observed both in one patient
4 P" ?' y0 e& ?/ c( Swho relapsed and in one patient in remission. Our results suggest that the+ y, {2 R9 F6 h+ I
characteristics of complete molecular response on dasatinib treatment may be
4 S2 m$ o5 _3 osimilar to that achieved with imatinib, at least in patients with adverse& @0 M- D+ X/ @& Y k! T. K
disease features.1 w7 v; w. Y; ]' Z
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