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。
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作者：来自澳大利亚
+ W, ]1 O$ I, ?2 e* y" g& c来源：Haematologica. 2011.8.9.
Dear Group,
/ s2 C! U/ n/ Y% T: p/ K7 C
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
6 l4 @% l! w! y9 wtherapies. 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.
* k% V: |( N- Q% i6 {) }3 H
The remarkable news about Sprycel cessation is that all 3 patients had failed
  U: Q4 x5 D7 t3 z# IGleevec and Sprycel was their second TKI so they had resistant disease. This is
4 f( b0 p; V* S8 x: A% \. ]different from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
; c- s$ u) w7 Z1 c6 M1 n3 C" W2 k
' y1 e8 c3 t1 \Hopefully, the doctors will report on a larger study and long-term to see if the
- g& U8 Q2 ?, B% rresponse off Sprycel is sustained.
& s% J! p  N  _' B
Best Wishes,
Anjana

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9 d$ K5 B: s2 w: F9 @8 P3 UHaematologica. 2011 Aug 9. [Epub ahead of print]
) V* x2 M4 w( g$ s$ Y+ D4 BDurable 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.
Source
4 c$ S2 I: W2 R& dAdelaide, Australia;
4 F8 k8 O8 `3 t
! J- ]* ~1 i3 s/ k6 v5 XAbstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
; H" Q  b3 M8 X$ H  Odurable complete molecular response might remain in CMR after stopping
% y: `$ n4 Z/ J, d2 V8 @" V1 J1 ytreatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
" V% l8 f' x' b2 x% Lcomplete molecular response more than 12 months after stopping dasatinib. In
) H: v" A: b) t# A% D1 c8 f$ tthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
show that the leukemic clone remains detectable, as we have previously shown in
! h; j( Z0 r1 e6 jimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
3 ^8 }2 O+ F5 |4 `5 Zthe emergence of clonal T cell populations, were observed both in one patient
% U2 e; i: O2 m+ b6 e& R& ~* qwho relapsed and in one patient in remission. Our results suggest that the
& I8 t2 c* o1 Q" _% scharacteristics of complete molecular response on dasatinib treatment may be
* K; z/ S8 b, M2 `similar to that achieved with imatinib, at least in patients with adverse
$ `4 ]: E( h8 }9 V; w  Bdisease features.

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。
( i: Z% F+ \- k* X5 h( @5 Q    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。
    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。
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1 _: z. K. m9 o, o+ |& l4 k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