关于停药的相关内容

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。
    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。

作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,
- F2 _2 m( A$ L% }' P7 l
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
  I* k8 C. d& Y. Etherapies. Here is a report from Australia on 3 patients who went off Sprycel
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
does spike up the immune system so I hope more reports come out on this issue.

The remarkable news about Sprycel cessation is that all 3 patients had failed
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
different from the stopping Gleevec trial in France which only targets patients
3 K: A; S/ M9 owho have done well on Gleevec.
6 Z* f9 ~  J" n" }
: _! R, `* w& E% N3 c6 eHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

Best Wishes,
Anjana



7 m- u, V& H( I0 i: zHaematologica. 2011 Aug 9. [Epub ahead of print]
  Y' i& s) v  r2 ~# T5 X' @Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
0 ]* D, a, I- @* S/ P( CSource
& I* m4 W; N0 w9 Y! |+ o" ?Adelaide, Australia;
: Q, X, L& R, ?# r0 L' _- _
4 h6 N( ?3 o( q! X# NAbstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
) C9 G9 B1 b) P  J  Z! ?durable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
+ k9 w7 K/ J7 @4 X. h* G) u. Hdescribe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
- e  Y- s' o: G$ Xcomplete molecular response more than 12 months after stopping dasatinib. In
1 b' Y5 R& S5 P& X$ [& ethese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
) n! F' Q+ C6 ^+ z, Sshow that the leukemic clone remains detectable, as we have previously shown in
5 I2 r- R8 r  V# ^# j& Wimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
/ e3 Q# r* o# Jthe emergence of clonal T cell populations, were observed both in one patient
( @! m) S' A5 ~* [. ~, _3 _/ iwho relapsed and in one patient in remission. Our results suggest that the
& N1 L/ u6 m6 q+ Ycharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
disease features.
$ H9 y# t! A# u0 r$ |8 ^

摘要：（STIM试验为法国的格列卫停药试验。）这个研究中，患者先是取得了CMR（融合基因转阴），然后停用格列卫，而后复发。15名复发患者在重新服药后又一次取得了CMR，他们同意再次停药。
    第一次CMR持续时间为31个月，然后患者停药，复发的中位时间为2.6个月，然后重新服用格列卫，中位时间5.3个月之后取得第二次CMR。保持第二次CMR中位时间19个月之后，患者同意再次停药，这次，15名患者中有5名在停药随访中位时间24个月后仍然保持了CMR，而10名患者在停药中位时间2月后第二次复发。
3 ?  \) ^! i, x6 `  Z1 U' d    请注意，这些患者都是在第一次CMR后停药然后又复发的患者。

! T* C9 c6 c: ~6 z7 a& L* v" i; |$ N$ a作者：来自法国STIM试验
来源：EHA 2011.6.会议摘要

很不错的文章，看来马老师家有考虑停药的想法了啊！祝福！

期盼易或特也能停药，但现在觉得是一个梦想！

这个非常有意义的研究。能吃下来停会再吃，再停，那是天大的好事