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。 }# I. E( w& e
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。2 N, L, B, f8 R: ^' L% u/ b. \
6 o( q, O& M% n, R1 z作者:来自澳大利亚
. p) o5 I/ V$ H/ [ q/ y P M* Q来源:Haematologica. 2011.8.9.# [2 t( g8 H- ?! g Q
Dear Group,3 ^! k) A) ^0 |, C+ e
* x. z/ `% d# ASome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
& Q0 \0 h0 s; Xtherapies. Here is a report from Australia on 3 patients who went off Sprycel
2 \; v* `$ z3 uafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
5 M- ^7 ~/ S/ V7 n) y2 |remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel2 X: n- O: b: Z* D6 l
does spike up the immune system so I hope more reports come out on this issue., ]+ A- t3 V. u& k# q0 V
W" N W, x4 ^; K o& `* ?1 |; K
The remarkable news about Sprycel cessation is that all 3 patients had failed
8 ~/ o0 Y* \! o k* {0 S+ D3 y, q- q8 }Gleevec and Sprycel was their second TKI so they had resistant disease. This is
/ _; x; y$ B) }1 Ldifferent from the stopping Gleevec trial in France which only targets patients* U% Y" _+ Y% d# X( `! x! U6 _
who have done well on Gleevec.! Z# m# D6 j2 \; j$ x# R; x" e
( i9 w2 M( L8 o" p
Hopefully, the doctors will report on a larger study and long-term to see if the
8 U3 Q# B, U ]response off Sprycel is sustained./ w$ H8 c' o4 L/ D( y
; M4 x) R3 e" ]5 Z5 H5 o8 Q; VBest Wishes,; B) i1 D0 w+ @* r9 S& i" T5 r
Anjana+ n- n* l0 _; q) o3 N! b
. \$ Y" [/ P8 v* {9 A' r* Z1 L+ G! `, p6 d
$ n: Q. X4 h/ u. VHaematologica. 2011 Aug 9. [Epub ahead of print]
8 Z( @ |/ U# w$ J( |Durable complete molecular remission of chronic myeloid leukemia following& C' m+ b5 i4 O' n1 h) h8 w
dasatinib cessation, despite adverse disease features.
9 g& R$ u) `; ^' U E7 m1 i9 o" aRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
# {% O$ R' A0 ^. H' ASource
1 e- i! H$ y* LAdelaide, Australia;0 m( @, z7 N/ p& O
. T1 U4 P' e6 O5 H
Abstract" g+ S7 d8 I6 b# B& b& p/ M
Patients with chronic myeloid leukemia, treated with imatinib, who have a
6 `- ^& }, u7 }' Idurable complete molecular response might remain in CMR after stopping4 Y% `" u) f8 a! }2 p
treatment. Previous reports of patients stopping treatment in complete molecular
. m( W4 E! Z: H$ Q8 gresponse have included only patients with a good response to imatinib. We5 P j* {5 i8 t/ b
describe three patients with stable complete molecular response on dasatinib
6 O8 Q8 j' I$ E3 Y5 w; L# J6 ftreatment following imatinib failure. Two of the three patients remain in
0 y4 c7 x7 c# S, dcomplete molecular response more than 12 months after stopping dasatinib. In) e; J( b3 Y2 d0 l
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
! C' }8 y5 B3 s2 ] ]% Tshow that the leukemic clone remains detectable, as we have previously shown in
2 q: ? |* C5 O' @4 Himatinib-treated patients. Dasatinib-associated immunological phenomena, such as
5 i( e h% R- Y( L* ]the emergence of clonal T cell populations, were observed both in one patient
; X. m/ g0 u+ s6 Kwho relapsed and in one patient in remission. Our results suggest that the! g. r8 {2 r+ v6 ~% l3 G" P3 `
characteristics of complete molecular response on dasatinib treatment may be) e& B. N- W" u$ k
similar to that achieved with imatinib, at least in patients with adverse( Y& Z7 M8 S4 k9 N
disease features.
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