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。% G2 f" a+ w9 w6 M8 T3 J
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。/ F0 L ^. d) c& U# G7 t* T# @
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作者:来自澳大利亚$ k! N( t7 U/ f; t( z
来源:Haematologica. 2011.8.9.
( v) ?& S) m z9 jDear Group,
$ V1 _; S, S8 X+ n6 j; `3 q: A
^( A3 z4 `6 SSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
! r5 z+ T& k5 p( x% g* x1 U8 Z0 ]therapies. Here is a report from Australia on 3 patients who went off Sprycel7 w- k! {$ U, D
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
) q! e. R0 N2 a7 f) R5 j, j* E3 Dremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel: C/ K2 `) O- a1 u
does spike up the immune system so I hope more reports come out on this issue.4 r* D9 @* L3 f
2 ^& \( E8 a6 S( TThe remarkable news about Sprycel cessation is that all 3 patients had failed; C8 X+ N4 T; t# b, Y2 R
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
# U" |3 J0 s4 y3 a2 wdifferent from the stopping Gleevec trial in France which only targets patients
: p+ D/ S$ N2 Awho have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the, D6 ?1 h+ e Z
response off Sprycel is sustained.$ y7 X* C5 b6 z9 K0 F+ n
' l1 t! Q! w' F* Q. V& q3 ~Best Wishes,
# g/ T* h9 i3 m. _9 [Anjana
& k& E( Z9 ~: X3 X) k) R! T
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" S' }" N% R. @4 b+ _5 hHaematologica. 2011 Aug 9. [Epub ahead of print]1 r1 j( U% E% Z* h# v& s% r* `' v
Durable complete molecular remission of chronic myeloid leukemia following
, b* Q. s% w$ A( ]+ R V+ H3 mdasatinib cessation, despite adverse disease features.0 @& N# x! I* W% B! j6 A
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
6 d2 y2 J2 c/ d/ Y4 H: c0 _Source
: B3 @8 r3 e% L: ~2 _Adelaide, Australia;" {3 b) i9 {$ a; f- H
5 R0 R3 C4 n4 s: V) NAbstract1 |* \' X0 N8 S1 L
Patients with chronic myeloid leukemia, treated with imatinib, who have a
( J0 G% A. b2 c3 S% t& {, Idurable complete molecular response might remain in CMR after stopping7 Z" d6 ~6 l0 l9 y% X9 W$ c
treatment. Previous reports of patients stopping treatment in complete molecular& j0 V. [! ]8 t! e: T! f+ r
response have included only patients with a good response to imatinib. We
; }) i2 @# R6 J( Jdescribe three patients with stable complete molecular response on dasatinib5 Z1 d( R% z. I6 }( t
treatment following imatinib failure. Two of the three patients remain in2 Y6 {7 ~/ H* O( s% M* k
complete molecular response more than 12 months after stopping dasatinib. In, Z# `5 o5 o4 H
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
% a- k. ]8 g K% W2 gshow that the leukemic clone remains detectable, as we have previously shown in, _% c; ^! V" g* ^" E8 U; j6 B
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as9 ~5 K( G2 U7 Q; b4 R$ X2 u& A! z
the emergence of clonal T cell populations, were observed both in one patient
0 ?( v$ \6 h8 D& V n7 ]# R, ^; vwho relapsed and in one patient in remission. Our results suggest that the
+ O2 x/ @1 n% P1 B/ Q! `( rcharacteristics of complete molecular response on dasatinib treatment may be2 u& d* D5 `. E _, P4 g$ X
similar to that achieved with imatinib, at least in patients with adverse
7 ]6 n' ~$ f5 r; ?disease features.0 b' E* J+ a& h+ Y9 O6 T& P
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