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。, v: R; `% y a
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3 \; z2 W ]* Z' {+ i+ G$ a
来源：Haematologica. 2011.8.9.
2 s4 G* ?+ |; @$ qDear Group,5 G% S2 [3 b8 s& X+ b5 Y$ X. _
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML5 i d! V: e( F% a6 v0 w
therapies. Here is a report from Australia on 3 patients who went off Sprycel
' {! Y4 ^/ }* P' \) I: |after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients4 L3 t& n: g" ~0 a; T
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
8 \) J, d0 \+ _! L- Ydoes 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( b* ~4 l5 v9 y0 ?& ] S
Gleevec and Sprycel was their second TKI so they had resistant disease. This is+ J& P) J: T, V4 ?- k8 {2 N& Y" \
different from the stopping Gleevec trial in France which only targets patients
' Y; F; E( L: E; `( \( w9 fwho have done well on Gleevec.
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9 E7 }4 A' w9 G' B( \Hopefully, the doctors will report on a larger study and long-term to see if the
0 m1 i2 q7 F4 rresponse off Sprycel is sustained.
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8 P2 W2 f" s0 ?6 P2 P4 UBest Wishes,
# z. l# a1 I* i6 {4 NAnjana
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Haematologica. 2011 Aug 9. [Epub ahead of print], {0 z+ o, }/ }, m) p: m
Durable complete molecular remission of chronic myeloid leukemia following- p8 Y, o3 T$ d. X$ y( S
dasatinib cessation, despite adverse disease features.
/ k" S0 t! z3 L0 ARoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.2 c0 P6 \/ S! G9 S7 h4 n' v
Source
5 O6 d3 i" @' J" I0 m3 r$ L1 w) bAdelaide, Australia;' ?" L( G4 s& H
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Abstract( a) ?" v8 k; @: F+ Q6 K- n+ ?% t
Patients with chronic myeloid leukemia, treated with imatinib, who have a: z9 J3 M5 e$ ^, }
durable complete molecular response might remain in CMR after stopping
) @# G9 L# l: h& T, j' }7 x( x( ]treatment. Previous reports of patients stopping treatment in complete molecular& t8 e, h2 j# S) h- Q0 {0 H
response have included only patients with a good response to imatinib. We, v0 h4 ]) \0 e. {/ u& z' L: Z
describe three patients with stable complete molecular response on dasatinib0 W3 b% b) B1 X7 Q$ L7 @7 o
treatment following imatinib failure. Two of the three patients remain in2 P2 I* d. D; D5 o0 {$ q. _) \2 d
complete molecular response more than 12 months after stopping dasatinib. In+ J4 n: W3 q# q/ f
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to+ D( I) o% w, I+ H+ @6 G( g, ], v/ e
show that the leukemic clone remains detectable, as we have previously shown in$ w( Q( C+ r1 F. G; |$ `( S
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as& P" P! S( `3 H8 |+ S
the emergence of clonal T cell populations, were observed both in one patient W& n# L) V$ d. s+ u
who relapsed and in one patient in remission. Our results suggest that the
. T" w" {6 v: @3 Y/ a3 Scharacteristics of complete molecular response on dasatinib treatment may be( I+ @# w, M) a c! ]0 H* M: m
similar to that achieved with imatinib, at least in patients with adverse6 n# H6 m+ }: g, d9 s
disease features.
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