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。
) ]% ~4 j* C% S7 H% g/ j$ G+ X 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。) o$ g4 G! B. U A& L
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作者:来自澳大利亚% b; ^, n2 L8 w; W
来源:Haematologica. 2011.8.9.
$ w1 E3 P9 V& {6 e, }Dear Group,
0 `5 L+ D+ f6 U8 ^6 G0 _+ P" B* R' `+ B2 Y( F5 N, U
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML5 _0 g* k; r: Y1 c3 v
therapies. Here is a report from Australia on 3 patients who went off Sprycel
, H% d$ t: i( c$ v' yafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients) |7 @& P5 G; i
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel J1 b1 [3 M$ N3 f0 s
does spike up the immune system so I hope more reports come out on this issue.
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8 F! h( }0 V( j9 T4 {* JThe remarkable news about Sprycel cessation is that all 3 patients had failed$ H* j% Y& a# p& ^$ n5 Y) h% R( S0 J
Gleevec and Sprycel was their second TKI so they had resistant disease. This is: W) I5 ~! T, v1 [3 s* W' j
different from the stopping Gleevec trial in France which only targets patients
6 u. i8 g3 J% h0 w9 l2 V( y2 pwho have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the* U- T# w* J* q# \8 d# U
response off Sprycel is sustained.7 Z* W: Z, C( V) p8 v& u# ]/ E
B5 y: j" w; b4 e+ g" r mBest Wishes,
: a) U- Y8 ]3 A! G2 J$ m% }& _Anjana! w, D6 G! @! R
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$ y: L7 l7 ?% ]' ~, v2 D9 B! _2 c6 J6 b
Haematologica. 2011 Aug 9. [Epub ahead of print]
! e/ X6 a/ x& `8 b5 y( B% d4 _; wDurable complete molecular remission of chronic myeloid leukemia following
, y* \# a) t# i+ x2 I. D9 g8 k/ mdasatinib cessation, despite adverse disease features.* \* I/ p1 L& G
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP., E9 }4 ~' m! r; Z
Source* g- [* B2 l/ E+ K7 z1 Z) [
Adelaide, Australia;* s( Q: p$ o9 x/ _' `
4 e( M& h( ^% PAbstract
6 j5 w* A% m) ZPatients with chronic myeloid leukemia, treated with imatinib, who have a
L7 K8 Q+ E* X; G, Xdurable complete molecular response might remain in CMR after stopping5 p, X4 } j7 `
treatment. Previous reports of patients stopping treatment in complete molecular
8 ]0 n: e( u1 N8 Sresponse have included only patients with a good response to imatinib. We0 ~5 ]! D* h8 A7 J/ E% C* D
describe three patients with stable complete molecular response on dasatinib% r( K6 N! H1 ~1 t7 J
treatment following imatinib failure. Two of the three patients remain in; j6 i4 L0 Q9 ^* \
complete molecular response more than 12 months after stopping dasatinib. In6 J. j3 l/ j& r1 [3 R
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to, ?% b( `, J) l# l
show that the leukemic clone remains detectable, as we have previously shown in
0 Z6 p5 D; P9 ]3 }- dimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
3 F- Q* ~ c/ B5 Fthe emergence of clonal T cell populations, were observed both in one patient
# d- t/ N; q* v' g) N$ N6 }who relapsed and in one patient in remission. Our results suggest that the
4 X3 r, m5 A# H6 V& f" J$ xcharacteristics of complete molecular response on dasatinib treatment may be
7 z1 t& T7 w7 {& d) nsimilar to that achieved with imatinib, at least in patients with adverse
3 A" }. @7 Z: T6 J8 x2 G p9 \disease features.2 g. e: M2 p* R" E. m2 P& O
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