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。
" C2 @, T8 {5 E7 d) W" t 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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- S! n* x* h, A5 W: H) p' f作者：来自澳大利亚
1 e( Q: R5 h# V7 S& W6 E/ ]+ Z来源：Haematologica. 2011.8.9.
8 e @/ Y6 F) H) IDear Group,9 u7 [6 b8 h! y: t
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML4 j* v' ^0 }0 U
therapies. Here is a report from Australia on 3 patients who went off Sprycel9 G% _: {' ~9 e4 R" f# x$ Z$ ^
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
% X* m% I( [" @, qremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
1 H' x3 a6 U2 U, T9 Vdoes spike up the immune system so I hope more reports come out on this issue.( A* q3 X. {- X6 [( j) X/ z% x E9 W
" ^: F: B$ e3 AThe remarkable news about Sprycel cessation is that all 3 patients had failed
5 g1 r5 A) m# d8 ~" e% E2 G1 w6 rGleevec and Sprycel was their second TKI so they had resistant disease. This is
8 o! N/ Y6 E. n4 ydifferent from the stopping Gleevec trial in France which only targets patients! a4 l! B! @9 F; S. x$ d
who have done well on Gleevec.% l/ ^2 ^: T3 a' r9 J$ Q
* p/ E2 e' m) _6 m5 ~$ FHopefully, the doctors will report on a larger study and long-term to see if the
9 K; L0 f# S2 c* Tresponse off Sprycel is sustained.0 _: x6 i1 G+ R( [
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Best Wishes,
, _/ N5 C" q' y* a9 OAnjana
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* [6 z' H: x& K2 p# h& ?Haematologica. 2011 Aug 9. [Epub ahead of print]; |! N. F/ n: ~6 ^' \/ Y- p
Durable complete molecular remission of chronic myeloid leukemia following7 ^6 @ r: ~- m3 g) T6 g7 m
dasatinib cessation, despite adverse disease features.
5 o4 K6 f$ t5 [. N5 pRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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Adelaide, Australia;1 k2 S; L2 R I+ Y- ^7 @
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Abstract
6 Z: v9 d$ Y U% m1 lPatients with chronic myeloid leukemia, treated with imatinib, who have a8 \' E( q8 ~6 e% t* ~1 a0 y- X
durable complete molecular response might remain in CMR after stopping. j# U6 W" A5 |
treatment. Previous reports of patients stopping treatment in complete molecular: ]% v2 Q# x3 Q: w* {( Y
response have included only patients with a good response to imatinib. We
}6 S' _: o9 Ddescribe three patients with stable complete molecular response on dasatinib
1 |+ l1 t3 D: O) utreatment following imatinib failure. Two of the three patients remain in
1 V! K" R7 }( z6 acomplete molecular response more than 12 months after stopping dasatinib. In
. @% t# U# Y2 s. othese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to' _ r$ S; P6 ?9 u0 m; N: B
show that the leukemic clone remains detectable, as we have previously shown in0 ]7 H" F. l+ T! u5 p7 f
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
8 i; h& {9 P! {, Q8 g0 P8 y: bthe emergence of clonal T cell populations, were observed both in one patient
0 r2 ^' f6 e7 ]2 @% vwho relapsed and in one patient in remission. Our results suggest that the, T6 \7 @4 M9 }, s- y$ b: `
characteristics of complete molecular response on dasatinib treatment may be$ J, s- d1 V+ E S$ [
similar to that achieved with imatinib, at least in patients with adverse2 t w( f: J+ B
disease features.- L, z3 ~) {& ?4 V3 Q! x/ \& I
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