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。
; z/ \# g( r! B* t. Y 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。
% |( O1 e% M2 R4 L2 }
: M# M8 K: A. e- e. ^) l+ d作者：来自澳大利亚( _% m9 n7 Y2 I
来源：Haematologica. 2011.8.9.
q" S9 i2 u7 r; c) pDear Group,/ g& N, `( D; y8 Z; g3 A
3 t `' c3 k( _8 W: P1 w5 {Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML8 p+ G& `7 q; k# [
therapies. Here is a report from Australia on 3 patients who went off Sprycel% ~3 D N% @" i% I' Q6 B, c
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients2 T; y8 k/ \3 q
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
. V/ E, ]: v h6 V! {, @does spike up the immune system so I hope more reports come out on this issue.
+ i( j3 @: a% X$ ^* g
9 K5 A) `. j1 {3 ]7 h" XThe remarkable news about Sprycel cessation is that all 3 patients had failed
# r6 h7 c, H0 d% \Gleevec and Sprycel was their second TKI so they had resistant disease. This is
9 U, G; \ z* M2 u' Gdifferent from the stopping Gleevec trial in France which only targets patients4 Y4 I7 H* u, d$ b+ M1 u
who have done well on Gleevec.
) y+ c" l e6 \, ~) }- ^ z* |" \$ `: Q0 D! E3 g3 N
Hopefully, the doctors will report on a larger study and long-term to see if the, b( `2 k0 q' f0 [3 g4 t7 F. D# C5 n
response off Sprycel is sustained.
/ Z9 J3 D$ k; t y8 l {, l; J0 q( E5 Y
Best Wishes,5 v, t3 h* }, I9 d8 o
Anjana
1 H. H) c' a/ ^$ T
2 R# i9 n& L! n- h* l! Z' p0 t
. W1 }, G( |& a9 f
$ G+ D) `7 Y4 O" y) THaematologica. 2011 Aug 9. [Epub ahead of print]- ~( b; q& i: | b' {/ q
Durable complete molecular remission of chronic myeloid leukemia following
$ F9 ]) @7 p5 e" P Y( P, ldasatinib cessation, despite adverse disease features.
. A$ o2 K: N3 R& e% ^& `Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.! u5 W, M9 K' a, v, v- n) l: k! |
Source8 M* _ s' C6 ~% P* R# s
Adelaide, Australia;7 v+ `6 t: q& U1 w2 q5 E$ z* x0 w
' I5 \, } G. D' h' s9 z
Abstract0 |8 d* Z* U+ ?4 A3 @
Patients with chronic myeloid leukemia, treated with imatinib, who have a) p+ R; C, T& A4 {5 u0 x" Y" |8 s
durable complete molecular response might remain in CMR after stopping
7 L0 @5 N5 r! O1 Htreatment. Previous reports of patients stopping treatment in complete molecular
' \% f f# I1 e0 P" F& [9 z* }response have included only patients with a good response to imatinib. We
8 n/ f# B0 {9 F) k* Q! Sdescribe three patients with stable complete molecular response on dasatinib
. |1 \$ ]9 I& Rtreatment following imatinib failure. Two of the three patients remain in0 V: i. e' O- t- c- ^
complete molecular response more than 12 months after stopping dasatinib. In
2 X- e* I8 o9 mthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
" ~2 e" M; W) L; dshow that the leukemic clone remains detectable, as we have previously shown in
1 y: E9 j! e# t7 b$ W4 Mimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
3 \8 p/ K6 i/ J. Pthe emergence of clonal T cell populations, were observed both in one patient5 i# B8 {. K; j. ^
who relapsed and in one patient in remission. Our results suggest that the
# [+ y# f1 s `. [9 E" |8 ?characteristics of complete molecular response on dasatinib treatment may be/ c+ c5 O8 d' D* N5 n
similar to that achieved with imatinib, at least in patients with adverse
3 v; A( Z' @+ ~ Q y! e, wdisease features.
3 B% e6 }6 g1 k% a |
显身卡
