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。5 L2 a0 K* e/ W' s4 U
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。
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作者：来自澳大利亚
4 e4 \; h" ]5 Z& C$ C来源：Haematologica. 2011.8.9., m9 M: V, A; f4 O
Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
0 y6 \: D+ }0 O& Gtherapies. Here is a report from Australia on 3 patients who went off Sprycel. C% A/ R6 U7 L. u1 E
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
X1 x6 v0 N; ^$ j, |3 }6 `remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel0 E& n4 D( N8 K
does spike up the immune system so I hope more reports come out on this issue.
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The remarkable news about Sprycel cessation is that all 3 patients had failed
/ R. O) s; V0 V/ y) t8 r7 bGleevec and Sprycel was their second TKI so they had resistant disease. This is! W( e* d! t! O: |3 c1 }2 e
different from the stopping Gleevec trial in France which only targets patients" [/ C! w7 a9 C: t; U: [8 }0 U
who have done well on Gleevec.' V- y6 Z2 M, \. L
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Hopefully, the doctors will report on a larger study and long-term to see if the: J2 \6 V4 A- o) g
response off Sprycel is sustained.
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$ S9 ~, s2 X( Y! j, M. z9 _* T1 n) eBest Wishes,
4 M. }: j" S% t8 _/ i1 eAnjana
+ R2 n5 d) m1 f% z8 C8 X& X8 a- \, Q5 q- W- ]# w
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5 E5 _9 d) X& M$ Y$ C ]- cHaematologica. 2011 Aug 9. [Epub ahead of print]9 R/ V$ t5 e6 O; h2 E+ q
Durable complete molecular remission of chronic myeloid leukemia following
% s" k4 P5 ?5 k3 P5 f9 f Z* C) `dasatinib cessation, despite adverse disease features.
4 H& t7 Q* H4 d- a' hRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
: j9 b' _" n, {8 B- ]- J. b# QSource
. F+ N8 P- C# B5 i, R; DAdelaide, Australia;
1 ?2 G- p+ ]+ A; K, R+ P9 c- |6 |8 L/ E7 m1 E! p a7 [
Abstract
P! j$ E Z; Q. x3 WPatients with chronic myeloid leukemia, treated with imatinib, who have a
9 i# u0 M1 i! J9 N& ]& ^durable complete molecular response might remain in CMR after stopping
" B3 ?1 Y. ]! B. Z7 ?3 ~treatment. Previous reports of patients stopping treatment in complete molecular
; u& T9 x& D0 `response have included only patients with a good response to imatinib. We9 P/ ^! d$ U+ d# T6 v$ }
describe three patients with stable complete molecular response on dasatinib
8 G7 n! O* b4 A# u9 G3 D3 W- V7 Xtreatment following imatinib failure. Two of the three patients remain in
+ k$ {: T% w" q: P5 r8 d3 o% \complete molecular response more than 12 months after stopping dasatinib. In1 p; V- V- V8 y
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
; T, }7 l3 t+ l" f% |, b: M7 Lshow that the leukemic clone remains detectable, as we have previously shown in
7 D/ G0 i3 ]( U6 oimatinib-treated patients. Dasatinib-associated immunological phenomena, such as- V# _* j6 Z6 d1 p2 ?* G4 I6 w0 _
the emergence of clonal T cell populations, were observed both in one patient
7 Z4 J) S; D/ Z- Q8 Q, r- B0 bwho relapsed and in one patient in remission. Our results suggest that the
- {2 s( j. ?/ q Z+ j6 _characteristics of complete molecular response on dasatinib treatment may be* B4 Q2 {2 f0 t
similar to that achieved with imatinib, at least in patients with adverse) }6 V. g( g3 l, s9 i; {' F0 B
disease features." X8 m4 e; k S' W6 J
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