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。
( ?* L9 Q! I" R& B 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。- f" G M$ H" h: W. H
- ?+ z" C& [7 Y作者:来自澳大利亚2 n' F8 J5 H) o$ V1 r8 V: t
来源:Haematologica. 2011.8.9.
; n+ `& i8 g: ~ y- f. O' u; `Dear Group,7 @6 u) D4 I& C. D0 }0 r
) r8 m' ]0 `" v* u- k& t& MSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML% W' }# _5 F, p* R2 @5 d
therapies. Here is a report from Australia on 3 patients who went off Sprycel
+ u6 n% T" j2 ^0 S& t2 Yafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
: r4 t, T; \- B& H* P; s0 V+ ~remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel4 ?6 j) z9 i! s) U7 m, D7 b
does spike up the immune system so I hope more reports come out on this issue.3 f$ w" |- Q( o& B5 j
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The remarkable news about Sprycel cessation is that all 3 patients had failed
2 A# u+ Z2 d+ x# AGleevec and Sprycel was their second TKI so they had resistant disease. This is
6 x) q7 b! G. @2 Y5 G ndifferent from the stopping Gleevec trial in France which only targets patients" a) v, w1 T& X% `- \- j
who have done well on Gleevec.
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& t ]! ?: `! QHopefully, the doctors will report on a larger study and long-term to see if the
+ J* c# D" M- M) I; o! t9 qresponse off Sprycel is sustained.
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' c9 l9 @% g- T' D8 y% B- rBest Wishes,5 w3 c8 X1 m) O9 R8 x- `3 K6 E
Anjana
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B5 L- j5 @+ V/ w; P* Q+ }Haematologica. 2011 Aug 9. [Epub ahead of print]
! N; v+ B6 b* t2 A; f( dDurable complete molecular remission of chronic myeloid leukemia following8 l: T5 o( O6 ~1 o
dasatinib cessation, despite adverse disease features.
6 @ H: u! J) VRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP. { ]* | }4 P4 F- E7 [
Source/ s0 s H0 x" f( o0 G, ?( T
Adelaide, Australia;/ a5 k2 P6 @3 y+ K; l/ \2 B4 ]/ Q- h5 K
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Abstract: @/ b( z% ?, T
Patients with chronic myeloid leukemia, treated with imatinib, who have a
: O1 K: o( r/ Ydurable complete molecular response might remain in CMR after stopping4 {! s. S o$ c8 M
treatment. Previous reports of patients stopping treatment in complete molecular2 h4 j# ?$ E" t g ?: [1 y- ^( O
response have included only patients with a good response to imatinib. We4 l8 S6 F$ c J) G9 C* n& C. D# h
describe three patients with stable complete molecular response on dasatinib, b: k( D0 G' F. U5 T
treatment following imatinib failure. Two of the three patients remain in
; a8 g d! h: ocomplete molecular response more than 12 months after stopping dasatinib. In: Q# a! [& p% m7 n
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
+ `% L6 K9 H0 s+ L- kshow that the leukemic clone remains detectable, as we have previously shown in1 x |- f" W' v$ r/ V* r' S3 c$ R
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as$ S0 ]+ I% \$ U2 ?9 ?& y% x4 v
the emergence of clonal T cell populations, were observed both in one patient" l# S0 Q4 ]' R, D
who relapsed and in one patient in remission. Our results suggest that the/ _( h4 k) i+ K5 h1 q1 m
characteristics of complete molecular response on dasatinib treatment may be
" o% x" [- x; R$ O/ ^' J! Qsimilar to that achieved with imatinib, at least in patients with adverse; F7 ~. S# @. T0 e; T( h
disease features.
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