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。
' T+ S' O0 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。 F2 z B& ?* j X2 T1 ^
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作者:来自澳大利亚
% s& H' Q' T" |5 v8 X来源:Haematologica. 2011.8.9.
, }2 M- J s5 s9 rDear Group,
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+ F/ S5 ^+ y+ Y% ~5 J. vSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
; h$ n4 K' I8 x# x3 J% ]/ ptherapies. Here is a report from Australia on 3 patients who went off Sprycel
6 f* f# m. x! c( }; p8 Yafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients! t: L J6 `, j0 ~- V" x% g
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel) c4 t- v+ Q- o+ u8 b9 y3 I$ C$ {
does 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
5 J" h8 l& o: Z* N3 R4 RGleevec and Sprycel was their second TKI so they had resistant disease. This is/ K! H. n! S* v5 i' Z$ B9 b" U
different from the stopping Gleevec trial in France which only targets patients: m5 V& b1 v: ~- M- c% R
who have done well on Gleevec./ _7 E \% @1 {% ^4 D! C/ }
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Hopefully, the doctors will report on a larger study and long-term to see if the
1 k. J6 _+ ]6 t) Kresponse off Sprycel is sustained.) ^6 Q* }- a5 i) O
0 p2 a6 U' ?2 z$ RBest Wishes,
2 \# V# d& f2 F. {. nAnjana w+ N& x- A% P. S) X4 i% Z
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1 o. |* v J" c7 C# }# |Haematologica. 2011 Aug 9. [Epub ahead of print]
6 O) s( x) B/ b7 RDurable complete molecular remission of chronic myeloid leukemia following
$ J P+ Z9 x0 A0 G# e, \) tdasatinib cessation, despite adverse disease features.
- g# b, p. m8 uRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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Adelaide, Australia;
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2 s: u9 a) p$ h1 A6 @. UAbstract
" T, \+ z& J+ _$ i9 k( t3 ^Patients with chronic myeloid leukemia, treated with imatinib, who have a6 G; A4 y$ `1 H! D1 M
durable complete molecular response might remain in CMR after stopping- J3 N3 _7 B8 Y0 F
treatment. Previous reports of patients stopping treatment in complete molecular. x: O( `. X$ [ k0 o
response have included only patients with a good response to imatinib. We
/ W8 }. _0 j8 |3 n9 Gdescribe three patients with stable complete molecular response on dasatinib# r2 s9 w1 A8 l/ q
treatment following imatinib failure. Two of the three patients remain in6 D' g' h; v1 x
complete molecular response more than 12 months after stopping dasatinib. In
/ L7 Q( J/ x& z1 Z1 k2 B- Z' ^these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to" E6 q; M( ]" K' q' @
show that the leukemic clone remains detectable, as we have previously shown in) K0 a1 i" L9 g5 W/ M
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
( m) Y# e% V2 k: o% X6 ethe emergence of clonal T cell populations, were observed both in one patient
, O! p" t' g1 i8 p- gwho relapsed and in one patient in remission. Our results suggest that the ~2 ]4 ]$ M y9 o; |, y$ l
characteristics of complete molecular response on dasatinib treatment may be, ~; D k( D$ c6 f9 I2 w1 {$ X
similar to that achieved with imatinib, at least in patients with adverse( v1 x/ T1 B+ V! [0 `2 }
disease features.
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