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。

" H& D3 }7 ?1 L0 W& d( h- [作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,

8 u) n) x7 B+ E6 F. V6 \. U& f) f) RSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. 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
- j0 @% \) P+ N) U$ O2 Mdoes spike up the immune system so I hope more reports come out on this issue.
. b/ U0 E! \& ~
The remarkable news about Sprycel cessation is that all 3 patients had failed
  y& Q2 o' D7 r" [5 ^/ t, ZGleevec and Sprycel was their second TKI so they had resistant disease. This is
# {. {% V9 t) e0 \6 O- A# Y- Kdifferent from the stopping Gleevec trial in France which only targets patients
# ^$ d5 A1 r- s! `2 H' ^  a: S0 Owho have done well on Gleevec.
) Y0 ]" g' ~) a% a
Hopefully, the doctors will report on a larger study and long-term to see if the
. V$ t0 Q# y3 @2 F) Iresponse off Sprycel is sustained.

Best Wishes,
) v, h2 B/ W, SAnjana
4 m7 {$ T/ E3 v. r/ d  Y


3 D5 r$ V, Q. }! @Haematologica. 2011 Aug 9. [Epub ahead of print]
( l$ s8 I( p+ X( a- [Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
5 W# I: F# _& u4 X+ H+ u5 L/ yRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
- ]4 p( U$ p) YAdelaide, Australia;
# [( p" z& ~; J- p
Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
2 d2 o, N# S! p6 E" h; `/ Xdurable complete molecular response might remain in CMR after stopping
) ?& i8 x" c$ }( |8 Rtreatment. Previous reports of patients stopping treatment in complete molecular
* o) h1 }$ Q* @+ lresponse 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
/ P- ?5 T: N5 e: q+ Tcomplete molecular response more than 12 months after stopping dasatinib. In
8 |/ y9 H" Z( Jthese 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
3 G: m" D& K5 Y: T- mimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
, B2 m1 q9 F, ~the emergence of clonal T cell populations, were observed both in one patient
who relapsed and in one patient in remission. Our results suggest that the
7 g& n& n0 |. a  pcharacteristics of complete molecular response on dasatinib treatment may be
0 j; x6 `  }' T. m- }, ?similar to that achieved with imatinib, at least in patients with adverse
  e* Q: ^0 F" ]8 `; S, Udisease features.
4 e7 P' o: E6 @7 M" A4 W$ }" ^

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。
    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。

$ a: m, O; d% z9 c4 ^( @作者：来自法国STIM试验
0 R  \* e2 _, F3 @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