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。
( Y' u& I# V: l( f 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。7 Q' J5 z" `9 |
, P9 w9 }* T# G6 V0 T6 r; y9 q. n作者:来自澳大利亚% J8 g% D& p; ~! h* h
来源:Haematologica. 2011.8.9.
* C5 m, b a! h6 q- g& h! HDear Group,: d( P& p. `2 o V: a3 d( W
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
5 y% W# V- B0 D% _7 |% [ Ttherapies. Here is a report from Australia on 3 patients who went off Sprycel8 `- L7 I) W( o8 k, @; M% W
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
1 j @6 x* N. P, [remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel& r) s+ A. {$ r* q6 Z( f, k
does spike up the immune system so I hope more reports come out on this issue.
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7 u) } S0 ~' D9 i. e% ~" jThe remarkable news about Sprycel cessation is that all 3 patients had failed
; {' u; Y5 u: v4 J9 h; U$ \Gleevec and Sprycel was their second TKI so they had resistant disease. This is
4 R3 ~3 e( g1 J% r `7 Y4 Ldifferent from the stopping Gleevec trial in France which only targets patients
5 d7 c6 O+ j swho have done well on Gleevec.
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& k5 s, d2 n3 A; H% M* U3 k- z) [Hopefully, the doctors will report on a larger study and long-term to see if the
3 s h0 E3 f9 g0 o! C# Iresponse off Sprycel is sustained.4 ?, J: s& Q- d2 w7 S5 P
; q' ^9 B$ k8 j2 p' aBest Wishes,8 t& F& A% v6 u$ U9 `! A! t
Anjana/ G( B, p5 g- g: n
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6 E+ b- `% ` K" bHaematologica. 2011 Aug 9. [Epub ahead of print]# A, S, Q# f: G* w* Y4 w$ y4 o
Durable complete molecular remission of chronic myeloid leukemia following
& z0 o! y" {7 }# Ldasatinib cessation, despite adverse disease features.
! i& I! O& |8 aRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
( |- t( ]& d( MSource
. Q$ X/ I) P& aAdelaide, Australia;
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Abstract
6 w* w$ v9 j# O# s# D& L7 TPatients with chronic myeloid leukemia, treated with imatinib, who have a) t, R* {9 }. T1 Z& B1 B
durable complete molecular response might remain in CMR after stopping
6 D7 o. p" Q7 o) B" a8 mtreatment. Previous reports of patients stopping treatment in complete molecular* N* n g4 ^( t* l* q
response have included only patients with a good response to imatinib. We
( Y+ C/ z2 V+ `/ C- m8 p, j1 edescribe three patients with stable complete molecular response on dasatinib# |; {3 S# M0 q1 p7 x% X
treatment following imatinib failure. Two of the three patients remain in" \7 \) k$ |/ @; m3 y
complete molecular response more than 12 months after stopping dasatinib. In
8 ]! |$ [( g/ hthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
6 l% R7 F p; W6 D0 h9 e8 Zshow that the leukemic clone remains detectable, as we have previously shown in! E/ }# x1 i; E8 _. f
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
1 e2 r: ^, t+ z" ^3 Athe emergence of clonal T cell populations, were observed both in one patient" p. @! b( Z( @4 G# K% ^6 d
who relapsed and in one patient in remission. Our results suggest that the
3 s$ Q1 i m/ i9 Q# z, ?( _characteristics of complete molecular response on dasatinib treatment may be- v! d- I9 n5 Z! ]: E. d$ m
similar to that achieved with imatinib, at least in patients with adverse8 `$ ^4 k. g5 V6 v$ l& C* {
disease features.
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