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。
) ], P; c4 J; l( e' [$ @ 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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p4 o$ w+ ^" T6 S, |) S作者:来自澳大利亚
M8 T3 ~& H1 k. [来源:Haematologica. 2011.8.9.
( B: |7 U$ Y" J# ]Dear Group,- r- t% W" ^$ m: C4 h' L
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
3 L# e1 ^6 \9 b- n. J" x7 Ntherapies. Here is a report from Australia on 3 patients who went off Sprycel
. U) `. F2 G* D( F7 dafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
9 _$ _& ^; `( ?# q A2 ~ Qremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel. g6 ^& z; Z9 J J
does spike up the immune system so I hope more reports come out on this issue.
9 k" m1 l6 ^' X/ t+ l+ n% [4 f a% z( |' V2 s) O
The remarkable news about Sprycel cessation is that all 3 patients had failed
! i& R2 l8 s; O0 }% u& J- CGleevec and Sprycel was their second TKI so they had resistant disease. This is# k, V) W9 D2 l+ r! |1 r2 s
different from the stopping Gleevec trial in France which only targets patients
+ e! Q* q" w' T' f, \who have done well on Gleevec.0 N* |6 S+ w4 e" v
4 I7 t ~# k4 l: p# |/ |Hopefully, the doctors will report on a larger study and long-term to see if the
% ^) v6 \7 W+ y2 G. }+ m% B/ S, W }9 xresponse off Sprycel is sustained.5 m; g( f9 a' n6 R" [# a
( h0 r+ }1 Q f- v6 A& iBest Wishes,
1 J. Z! V0 b" P) u, h, {! hAnjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]/ ?, r. {, B$ q9 _: {- I
Durable complete molecular remission of chronic myeloid leukemia following) F% x9 }! m' _) `
dasatinib cessation, despite adverse disease features.
) _5 W4 j9 Q: ~( YRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP., A0 e( |& f- ^& t
Source
$ g. E( P' ]; }" s, X# dAdelaide, Australia;. R# I5 g5 V8 ]/ v! K
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Abstract3 F0 \2 t p% H1 r7 C+ _
Patients with chronic myeloid leukemia, treated with imatinib, who have a
" D7 V/ g8 I# i5 [+ J( Udurable complete molecular response might remain in CMR after stopping
. {9 \. }% H! @- u1 S, Dtreatment. Previous reports of patients stopping treatment in complete molecular
' l- X2 l- n# f6 h- lresponse have included only patients with a good response to imatinib. We' d' |2 v- h/ k9 o/ E
describe three patients with stable complete molecular response on dasatinib
! t' w6 q7 \% {3 r/ P' dtreatment following imatinib failure. Two of the three patients remain in5 ^$ B u2 Q: _; K$ L
complete molecular response more than 12 months after stopping dasatinib. In; }2 M, |) Z+ @+ M* O
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to* r" U1 n& `! T8 N/ C
show that the leukemic clone remains detectable, as we have previously shown in
5 |, n5 H4 u, `- z# himatinib-treated patients. Dasatinib-associated immunological phenomena, such as
& i! m# |- B: K6 X: ythe emergence of clonal T cell populations, were observed both in one patient o: A# A, Z# p$ _) g% L- O5 ]
who relapsed and in one patient in remission. Our results suggest that the% |5 @1 E; _& {! g* S; K. H0 L8 U
characteristics of complete molecular response on dasatinib treatment may be
. F+ O4 U4 q' w7 ] [. R$ y! psimilar to that achieved with imatinib, at least in patients with adverse
3 N$ l( a9 S0 I% j1 Q- Tdisease features.
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