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 D% w5 |: U1 Y0 Y! ~5 Z4 n
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。( m* Y, a9 |0 f6 b9 v$ a
1 a6 B, W8 L: c; Y" X" Q- f作者:来自澳大利亚
, r0 P# K- R% ?) U* a k( K, \" T4 n来源:Haematologica. 2011.8.9.5 \0 A3 D- Z# f+ a5 d+ H& H
Dear Group,& D. r) c+ A4 Y
4 S ?3 P7 c. D/ w3 \9 H6 i" S4 vSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML; q3 V0 C6 x/ q, }# G0 F
therapies. Here is a report from Australia on 3 patients who went off Sprycel8 E; Q5 z& h/ n7 x7 a {
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients$ J& a* B5 m3 f, t! E1 q
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
4 x( y" x3 O" I1 adoes 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 failed2 ]8 u* V. O+ T3 a: G8 r
Gleevec and Sprycel was their second TKI so they had resistant disease. This is& V/ y4 ~3 x: A9 p$ R, G) j
different from the stopping Gleevec trial in France which only targets patients
# s6 y9 w; c4 ]8 w/ B9 owho have done well on Gleevec.0 m: k: l2 A$ n: E& B5 O# O. Q
/ B. }! ~3 A IHopefully, the doctors will report on a larger study and long-term to see if the
- E4 n0 K \6 A! J2 z, Bresponse off Sprycel is sustained.
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Best Wishes,
5 T4 r" F- {& Y; m0 wAnjana$ k7 N0 Z k+ ^( ]# @
, _; [& g9 o0 p" {% p) N6 J
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& e8 S& o# i# Y* _# d6 h7 Q3 SHaematologica. 2011 Aug 9. [Epub ahead of print]4 g- A2 T% V& A5 _8 Z
Durable complete molecular remission of chronic myeloid leukemia following* _4 |" k# f3 {: |) I0 @9 ^; l
dasatinib cessation, despite adverse disease features.
) n+ R# ]9 J+ E, }4 \+ u' ]Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
C, @4 V* ?2 R u8 KSource' O \6 n, m! |1 X
Adelaide, Australia;9 J, D0 j- \1 z" X, [5 O
! l1 }5 X+ s3 R3 e% r# i
Abstract/ }9 q* r6 B3 x. O
Patients with chronic myeloid leukemia, treated with imatinib, who have a
8 Z: Q3 e& `6 Qdurable complete molecular response might remain in CMR after stopping
: G& U! D- u: Q$ F# t# otreatment. Previous reports of patients stopping treatment in complete molecular+ k% S: v( `9 n9 P; L
response have included only patients with a good response to imatinib. We
/ ~. p ?* d. p- A7 {describe three patients with stable complete molecular response on dasatinib* a# d! p- h' q- N
treatment following imatinib failure. Two of the three patients remain in0 n7 j) ^4 i, T% m8 W2 R
complete molecular response more than 12 months after stopping dasatinib. In
9 W2 c: S u# U' j6 J! ethese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to: ~3 w$ G) P+ b% ^. ?
show that the leukemic clone remains detectable, as we have previously shown in
" [$ |6 _, j- _) L, Rimatinib-treated patients. Dasatinib-associated immunological phenomena, such as, g. w; o5 S2 a* t2 U6 A' T% V$ i
the emergence of clonal T cell populations, were observed both in one patient
# j- A, ~! ^* z3 ]who relapsed and in one patient in remission. Our results suggest that the9 l, d. g/ Y6 @( F
characteristics of complete molecular response on dasatinib treatment may be1 `3 M' r( ?, N0 ^2 K& R j
similar to that achieved with imatinib, at least in patients with adverse9 i8 ]8 m. d0 k q. {7 s5 G
disease features.
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