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。+ R. M5 a' R1 \" v
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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4 A0 R& o, p8 Z! I( J* T, z8 |作者：来自澳大利亚
5 f1 t' w1 F9 R1 n8 I! `来源：Haematologica. 2011.8.9.
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
2 {3 o' m% {0 m" Qtherapies. Here is a report from Australia on 3 patients who went off Sprycel
+ r3 R* L# U* O& Yafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
+ ^ L$ v" {- Z m0 q c* N+ ^remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel. }0 j7 a0 {6 g
does spike up the immune system so I hope more reports come out on this issue.3 C( s8 p( o3 q9 s6 Q
$ a0 j, f) L+ V: i( f# Z* bThe remarkable news about Sprycel cessation is that all 3 patients had failed/ b/ U" U/ L9 W- g' v9 ]
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
9 F: K( F( q& L4 v Z1 kdifferent from the stopping Gleevec trial in France which only targets patients
' {1 d$ ^; n& U. ]who have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the8 I* R0 k% E1 k* N
response off Sprycel is sustained.
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Best Wishes,
' m/ m7 C: b- H1 LAnjana
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: F+ i) K3 O2 S# q) O4 Y# J5 S- AHaematologica. 2011 Aug 9. [Epub ahead of print]) [. o- V9 R7 r6 n) H& t; I& X; x
Durable complete molecular remission of chronic myeloid leukemia following
+ b& b. d3 A( A! Z0 p& T$ B* ydasatinib cessation, despite adverse disease features.
: {7 x& W) P0 ~9 fRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP./ Y- f) B; F- {5 [1 Q3 \% G2 v
Source. [. N2 X/ Y7 [, ^
Adelaide, Australia;
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Abstract
# _' _1 |' Z% K5 W1 u0 V& FPatients with chronic myeloid leukemia, treated with imatinib, who have a- V# J7 T9 t5 v( `6 Z
durable complete molecular response might remain in CMR after stopping/ D) ^' N2 G. P
treatment. Previous reports of patients stopping treatment in complete molecular9 y' s5 J5 a* `9 ^2 t: C; T( p
response have included only patients with a good response to imatinib. We) e8 i* D+ L: w- x- R+ N" L2 q0 }
describe three patients with stable complete molecular response on dasatinib
2 C, b! g( f# n9 |2 S' D) e+ ~$ Ytreatment following imatinib failure. Two of the three patients remain in$ B: D# r# B: ~7 l. Q* j
complete molecular response more than 12 months after stopping dasatinib. In
+ E$ v6 d- ]# dthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to, w L- |. P& z5 g4 p8 n
show that the leukemic clone remains detectable, as we have previously shown in
. U* }0 X. `8 ^& ?imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
: r" N I( M1 G3 k" I& | N0 Xthe emergence of clonal T cell populations, were observed both in one patient
+ d3 o/ q% k1 w9 ewho relapsed and in one patient in remission. Our results suggest that the9 o' t0 W$ K9 V# E" [6 P) n* m
characteristics of complete molecular response on dasatinib treatment may be
4 E3 q0 }' l' q, u: `* c! n: M$ zsimilar to that achieved with imatinib, at least in patients with adverse) ]0 l" p( ?- P6 I b" r
disease features.
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