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。
$ B1 J5 D' |; ?1 v+ F% Z7 v; V0 K 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
/ ]( W: N' F3 _- Y) _. s8 g' ^来源:Haematologica. 2011.8.9.: Y5 N f. \- f9 s1 Q9 m& C
Dear Group,
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% a: i4 e+ E$ j+ L; kSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
5 V1 R) _3 h4 S: x" q4 p+ Otherapies. Here is a report from Australia on 3 patients who went off Sprycel1 @0 G/ P, L8 g T; V, ?' o
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
( p9 T0 S& E2 A0 ~, Jremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel* j* [( ]5 y6 H1 U3 C! h9 x- y+ g
does spike up the immune system so I hope more reports come out on this issue.* R5 c p' z! l, N
3 |, @$ r; R& G2 z' M5 m+ `- R( u* u4 aThe remarkable news about Sprycel cessation is that all 3 patients had failed, J4 x1 l! ^9 u# W6 k6 G# |2 W; r
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
) Y4 Q0 k/ I K! ]2 ?, udifferent from the stopping Gleevec trial in France which only targets patients: B1 d/ H6 \9 h6 \( U' G- v, m! @/ p
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 the: E0 H! `& D: s* A% A3 c0 E
response off Sprycel is sustained.% `: o" w+ S+ x$ g
) D( t* h3 m1 ABest Wishes,, v9 e7 A; c: u/ C5 C4 C
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print], v; N+ ^0 Q( p- t& E6 b$ {
Durable complete molecular remission of chronic myeloid leukemia following2 F0 E# @$ a. e- E2 W' B
dasatinib cessation, despite adverse disease features.5 u" E5 C! D' x2 n+ D1 Q2 m! |' |
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
0 J" m+ c8 W! _1 ]Source
; V ~/ s ]9 T3 [5 x% |Adelaide, Australia;
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; e- v) u' C- a, z- [: C$ F# IAbstract
! F% z% P; r- s5 U$ k- |" Y0 e; z- KPatients with chronic myeloid leukemia, treated with imatinib, who have a8 E6 ~; Q/ K3 s' u2 }
durable complete molecular response might remain in CMR after stopping$ o4 K. }+ Y, M7 n. C
treatment. Previous reports of patients stopping treatment in complete molecular
/ ]1 |6 i" x0 K. l8 X1 aresponse have included only patients with a good response to imatinib. We" o4 i! Q s2 F: g) a
describe three patients with stable complete molecular response on dasatinib
% ?3 D% |9 P% y& I! \2 t# G Qtreatment following imatinib failure. Two of the three patients remain in2 {- B0 v* E8 J3 s9 b
complete molecular response more than 12 months after stopping dasatinib. In& n3 k4 [& v% L! A
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
" S! v- S& V7 L8 b+ P% Pshow that the leukemic clone remains detectable, as we have previously shown in; E; F3 j6 o5 p+ d m' G
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as/ o5 |; d' l0 _9 Y
the emergence of clonal T cell populations, were observed both in one patient
5 W1 ~. L( d' b, {) rwho relapsed and in one patient in remission. Our results suggest that the5 k) [1 H8 f+ h/ `
characteristics of complete molecular response on dasatinib treatment may be% p% [8 `& J3 a, z% |' a( s) t
similar to that achieved with imatinib, at least in patients with adverse) f1 g% G" I4 Y( M0 X* X) H
disease features.$ X% K0 E$ @# E( ]& t
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