关于停药的相关内容

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。
    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。

作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,
: W7 V9 ?/ p& s$ S% N) c  w
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. Here is a report from Australia on 3 patients who went off Sprycel
. q& w  Y% z$ u  M6 @after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
! I' v* ]# h- G( s0 m6 T2 l' O* R0 Idoes spike up the immune system so I hope more reports come out on this issue.
2 s; ~1 b  o" a! q2 K+ e% r& l
1 n: M) ^- X, E0 c0 {' `The remarkable news about Sprycel cessation is that all 3 patients had failed
% T& p9 u9 D# l1 @8 uGleevec and Sprycel was their second TKI so they had resistant disease. This is
  l! P) c, I6 W+ u; y; I7 P) Wdifferent from the stopping Gleevec trial in France which only targets patients
, c: H  x5 U  W5 a8 Rwho have done well on Gleevec.

! n6 v; R5 q! R8 x+ C3 y5 aHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
0 D9 E* |0 d  K2 T
Best Wishes,
Anjana
3 u% b- q0 O* X9 D7 f" A1 Z


4 v. R9 K* I: `/ Q( UHaematologica. 2011 Aug 9. [Epub ahead of print]
* E7 q6 B0 R$ V' vDurable complete molecular remission of chronic myeloid leukemia following
; M, \/ T7 f( R) O) z, r2 gdasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
+ c$ W/ N/ a; F* I1 lSource
4 ?" m6 x& x/ hAdelaide, Australia;
& P: }' Q+ [, V/ K! p
Abstract
6 G: V5 ~. a. X( R. n1 ~Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
. A- v  f. ?/ F4 btreatment. Previous reports of patients stopping treatment in complete molecular
- ~' ~' z. a* H4 _# @% qresponse have included only patients with a good response to imatinib. We
! g) g$ _8 r/ ~/ G. V' d# Qdescribe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
1 M3 D9 q% ^4 O5 ^2 g, I) e4 pcomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
9 h: F/ [$ e( E2 \' r2 _0 ashow that the leukemic clone remains detectable, as we have previously shown in
& G% W" R0 ^: o* Z# K) T; }. Limatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
: h0 x2 B* p  Kwho relapsed and in one patient in remission. Our results suggest that the
$ W2 b8 P. k+ l* `# z( [2 Y- Y' ]characteristics of complete molecular response on dasatinib treatment may be
, M. Z5 g8 ~! f! Rsimilar to that achieved with imatinib, at least in patients with adverse
+ r% ]( S/ v- k  v3 x# E* M: N& N& jdisease features.

摘要：（STIM试验为法国的格列卫停药试验。）这个研究中，患者先是取得了CMR（融合基因转阴），然后停用格列卫，而后复发。15名复发患者在重新服药后又一次取得了CMR，他们同意再次停药。
# B) j9 G; i* d4 v+ ?    第一次CMR持续时间为31个月，然后患者停药，复发的中位时间为2.6个月，然后重新服用格列卫，中位时间5.3个月之后取得第二次CMR。保持第二次CMR中位时间19个月之后，患者同意再次停药，这次，15名患者中有5名在停药随访中位时间24个月后仍然保持了CMR，而10名患者在停药中位时间2月后第二次复发。
    请注意，这些患者都是在第一次CMR后停药然后又复发的患者。
+ ]/ e' l0 Z- @7 A( y& H
+ T5 v, L6 l7 {8 S  ^& K( f作者：来自法国STIM试验
来源：EHA 2011.6.会议摘要

很不错的文章，看来马老师家有考虑停药的想法了啊！祝福！

期盼易或特也能停药，但现在觉得是一个梦想！

这个非常有意义的研究。能吃下来停会再吃，再停，那是天大的好事