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。/ M! O. `2 \" T5 s% |2 e5 N
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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5 j1 |8 m* x$ n- l作者:来自澳大利亚* I n, Q6 C+ A5 P; c, B& A
来源:Haematologica. 2011.8.9.
: j/ b& W! w& T# FDear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML5 J, X* ^8 }5 s# Y4 T7 ^6 j( Y
therapies. Here is a report from Australia on 3 patients who went off Sprycel
9 M/ p9 |2 W2 uafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
( v* t; d2 |' o* y" a7 R; t S' lremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
8 @9 w$ |' F @! a# S% B8 Zdoes spike up the immune system so I hope more reports come out on this issue.
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% b2 `6 `; W( I7 w j& qThe remarkable news about Sprycel cessation is that all 3 patients had failed! [" I/ c8 i) G, ], r/ p% F4 N
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
9 g2 Z: k( Y5 cdifferent from the stopping Gleevec trial in France which only targets patients
* D" e4 J' [7 Q5 `6 [who have done well on Gleevec.9 z6 _. F9 i( { P
; |0 q+ }/ E/ s$ jHopefully, the doctors will report on a larger study and long-term to see if the- l# J# C. R6 @8 o! @# H- ?5 Q/ }
response off Sprycel is sustained.# t8 `1 G" l- j, w9 B" n
. A& D1 r$ l& T9 I3 x) _& SBest Wishes,9 v" D; H; ^: X, a
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]- c2 M9 w( I# h9 ~: w+ P! z
Durable complete molecular remission of chronic myeloid leukemia following- t* {& u) j8 t% B% {4 y. L
dasatinib cessation, despite adverse disease features.1 s, O4 c; T# l- p
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.7 w! ^: h; m7 r. `( @. G
Source6 ~0 E d1 g3 {& d
Adelaide, Australia;
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Abstract
! l4 g- z0 A: JPatients with chronic myeloid leukemia, treated with imatinib, who have a
0 i( Y9 A/ k( `) Adurable complete molecular response might remain in CMR after stopping: z1 Z9 f y! {
treatment. Previous reports of patients stopping treatment in complete molecular7 s- z: M8 e0 p2 N# B
response have included only patients with a good response to imatinib. We: u t/ R( o+ [9 f; M4 w
describe three patients with stable complete molecular response on dasatinib, r9 @, ~4 n* q; S5 O' Y4 _
treatment following imatinib failure. Two of the three patients remain in( }/ o z" q$ v. q- x0 @ q1 j
complete molecular response more than 12 months after stopping dasatinib. In
& {1 j% a4 y" z& W! z. @0 ^$ s% ]these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to x* p! d7 W& n% K; E& ?
show that the leukemic clone remains detectable, as we have previously shown in
: o* t3 N5 i# N: ^; [imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
: [/ {7 R$ U% c, c" wthe emergence of clonal T cell populations, were observed both in one patient: A3 s: b% l3 F8 P: Y( C# k
who relapsed and in one patient in remission. Our results suggest that the
& K; y+ F' f; L3 A* B$ J) E1 a; Dcharacteristics of complete molecular response on dasatinib treatment may be
3 P- ~: _- g4 E6 Y; a( h% \3 d8 asimilar to that achieved with imatinib, at least in patients with adverse
# J4 D& T- I1 C# ?" n/ Hdisease features.* N6 Y% `) E% J# p' M2 x$ b5 R3 Q. ~
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