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。
Y- z8 q, _3 Z7 z 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。
7 s+ S9 w7 ^# r, F7 C- v8 } U
# Z( ?7 s7 o5 @作者:来自澳大利亚- u9 M2 [9 k8 k1 t
来源:Haematologica. 2011.8.9.2 ~4 J4 l- M# G% Z m
Dear Group,
$ h$ U! T2 G' e: J7 M* p
# V# k% d. H. v) ZSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML6 O. y. K5 P: f6 B9 D
therapies. Here is a report from Australia on 3 patients who went off Sprycel5 h. B! g2 g$ v
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
& N1 Z% ?5 t% l2 L9 p2 Iremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel% D/ R3 {" H9 b
does spike up the immune system so I hope more reports come out on this issue.
@/ U4 x" [1 ~# Z6 M- c
3 `/ |9 s$ m; z: ~- ]The remarkable news about Sprycel cessation is that all 3 patients had failed# S# H+ {/ Y: h
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
! a2 {) K. }, G. ]# g$ wdifferent from the stopping Gleevec trial in France which only targets patients" B+ k! J; Q2 T
who have done well on Gleevec.6 S, n. A/ c# @: l" j; _7 X
, k- i( F( D q: F( cHopefully, the doctors will report on a larger study and long-term to see if the
( u* m8 @5 _& h) a4 I, kresponse off Sprycel is sustained.
* D% n3 q6 S# b$ I# ?" D
8 Z8 e+ p# E0 ]+ Q6 r" y/ ZBest Wishes,
$ w7 y* ^% m) M0 r, p/ T2 m0 j/ _Anjana
* w8 h6 O+ @1 e3 R2 O$ E& N
5 \9 X6 P* B& k2 b
& p7 D% f. i5 {- G0 j% e" { X& |6 h4 ~! S( I
Haematologica. 2011 Aug 9. [Epub ahead of print]/ ?7 ?( b! {4 o3 ?$ w
Durable complete molecular remission of chronic myeloid leukemia following: y: y% \" q# Q) t; a$ k5 M, ]! S
dasatinib cessation, despite adverse disease features.
, q2 i4 K# @' o3 E7 Z; _0 yRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.; X; S6 }1 c c9 }/ I
Source% G- O4 ~: O% c
Adelaide, Australia;0 t: U- n* |' P l
( |" {) h: |: D' E
Abstract
+ k/ d" _5 E0 dPatients with chronic myeloid leukemia, treated with imatinib, who have a
- s$ J2 w) h1 t! n1 q6 Gdurable complete molecular response might remain in CMR after stopping
) J/ x: R& i1 R6 vtreatment. Previous reports of patients stopping treatment in complete molecular, s5 A) L5 F% o6 h/ y" K1 \
response have included only patients with a good response to imatinib. We! A7 y: L& Q' W" Y6 q4 l" s
describe three patients with stable complete molecular response on dasatinib$ \. e) k, n; e2 l( `
treatment following imatinib failure. Two of the three patients remain in
0 L% m, s h# }% r# V; S% _5 x* Xcomplete molecular response more than 12 months after stopping dasatinib. In0 t+ h1 \4 q; c) b4 A! P
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to% S. w; ?5 M R- `% S8 H; s
show that the leukemic clone remains detectable, as we have previously shown in, g N( _' B) {
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as2 s0 o2 x: R1 o2 Y7 k
the emergence of clonal T cell populations, were observed both in one patient
9 n6 [6 C" Y/ K* Y" V3 Qwho relapsed and in one patient in remission. Our results suggest that the. x! r$ ?( i' W7 O0 T9 R
characteristics of complete molecular response on dasatinib treatment may be
9 `1 q! ^( t% R4 {+ n& s5 `similar to that achieved with imatinib, at least in patients with adverse
$ ?, F+ _! W7 `* c! K7 ^disease features.
* k8 I5 ?/ }- T/ L6 Y( L1 X |