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。8 A( S# O; h$ R2 u* {" }
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- [1 t1 K" L8 H6 t7 {6 T
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作者：来自澳大利亚# G% T, S( j# U8 d- S
来源：Haematologica. 2011.8.9.
$ l: ~0 a( A/ W# |; x/ D3 h: MDear Group,2 y; p" w2 E& ]/ P" t1 V
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML. H$ ]: }: T' y; m
therapies. Here is a report from Australia on 3 patients who went off Sprycel/ f! Q: H: Z9 O( x( s8 T/ S
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
* C& L9 \* Y) {$ lremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
+ o$ Q+ u" U$ N$ Udoes spike up the immune system so I hope more reports come out on this issue.
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The remarkable news about Sprycel cessation is that all 3 patients had failed: N3 @& C$ X- A, _6 f7 C
Gleevec and Sprycel was their second TKI so they had resistant disease. This is- G1 c8 i/ t& G' D0 S8 R2 z
different from the stopping Gleevec trial in France which only targets patients
7 j0 k! F; s& s1 _6 [9 }who have done well on Gleevec.$ K) D' f) ~) Q+ b% b+ k- @' a1 Z8 ]
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Hopefully, the doctors will report on a larger study and long-term to see if the2 E- f9 T5 x! |- j4 f1 v8 p
response off Sprycel is sustained.
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" H* b+ q! c& }: f, G. PBest Wishes,5 M0 N& U c( T& i
Anjana$ U! _" {; P6 b3 u3 s3 m$ ?8 v: r" E
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Haematologica. 2011 Aug 9. [Epub ahead of print]
; _" I% S# i( [: c8 F( y( _3 X/ gDurable complete molecular remission of chronic myeloid leukemia following, G& r! W% C+ Y! G6 w
dasatinib cessation, despite adverse disease features.# G j( o. z, T* A
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP./ @+ q$ k2 V9 n* V5 O5 p8 N
Source1 N% L# R, H0 l7 A
Adelaide, Australia;7 q/ F# X( p& Y" d
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Abstract) u7 }% j2 m2 P6 c9 J) [( F2 a% u
Patients with chronic myeloid leukemia, treated with imatinib, who have a6 Y7 b& [# B5 b$ P1 s" Q* s/ Y
durable complete molecular response might remain in CMR after stopping4 k' a9 h, A8 o' k) z2 Y$ H
treatment. Previous reports of patients stopping treatment in complete molecular% j E" e+ b1 O Q" A. @$ g
response have included only patients with a good response to imatinib. We( P0 a, ?8 `- W8 Z4 V
describe three patients with stable complete molecular response on dasatinib
; v- Y, v# d+ V8 {$ r1 x3 Btreatment following imatinib failure. Two of the three patients remain in0 S4 p/ C& G! r1 s* L% ]& N8 G
complete molecular response more than 12 months after stopping dasatinib. In
: Z# F8 l9 R: Q: w* |( Ythese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to; B# U! O0 ]7 N. \( y
show that the leukemic clone remains detectable, as we have previously shown in
' E4 N- @+ Z8 b4 d0 ]- Eimatinib-treated patients. Dasatinib-associated immunological phenomena, such as( ?- x9 E5 A$ _: K
the emergence of clonal T cell populations, were observed both in one patient
. E5 c1 A1 n% ?; ]+ @& Qwho relapsed and in one patient in remission. Our results suggest that the. l: P9 u+ ^: D1 G
characteristics of complete molecular response on dasatinib treatment may be
8 S4 E8 S# A" B- Tsimilar to that achieved with imatinib, at least in patients with adverse
, p, e( A: ~# |; \/ I: Q- xdisease features.& z7 ?: c$ |( V! [) H
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