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。) U4 U, [3 M V$ v* b
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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作者:来自澳大利亚1 O1 Z' Y+ D* u! m
来源:Haematologica. 2011.8.9.
3 Q& J6 [0 F% EDear Group,
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" j5 h: o4 k2 |, n1 USome of you are on Dasatinib (Sprycel) and we wish to give news on all CML$ K5 \# |6 T, S0 x j3 s6 t& ]7 J
therapies. Here is a report from Australia on 3 patients who went off Sprycel. B7 E* K5 M# h% Y) k" l2 g
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients! [1 ?0 w9 _: z2 g8 T0 y
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
# |: E. `6 p3 S; ]" xdoes spike up the immune system so I hope more reports come out on this issue.' r- m( k9 M# d x4 h+ a: s+ }
# X$ C$ Y0 ~! K3 X4 j! h4 F1 JThe remarkable news about Sprycel cessation is that all 3 patients had failed
' N* f6 T+ w9 V8 D% O; dGleevec and Sprycel was their second TKI so they had resistant disease. This is! U4 o: M8 X6 F0 M
different from the stopping Gleevec trial in France which only targets patients
/ Y L# T: i/ u! p, G& Wwho have done well on Gleevec.3 ^ F3 ]( Q# }5 G7 e0 @
7 c) J# H, P- z4 p8 f1 EHopefully, the doctors will report on a larger study and long-term to see if the. ~% J+ ?% s( V9 F( O( y
response off Sprycel is sustained.
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0 @4 n# I/ Q5 B; b( K2 |/ oBest Wishes,
r! M8 T2 g# z# gAnjana- C7 l# A7 c- g7 O. i+ M5 B$ G
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Haematologica. 2011 Aug 9. [Epub ahead of print]( b& A6 w m5 [+ f- W% O
Durable complete molecular remission of chronic myeloid leukemia following2 F8 q) ^! Y0 a+ z5 Z( d$ ]
dasatinib cessation, despite adverse disease features.
/ R1 {2 x) s$ U& `. Z# WRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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Adelaide, Australia;
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. b) E% ?. D8 S5 s2 |+ r/ `2 lAbstract i: b- B* Z+ t) g. P$ ]6 L
Patients with chronic myeloid leukemia, treated with imatinib, who have a- _ s9 g9 F% m6 Y
durable complete molecular response might remain in CMR after stopping
3 C9 J; j5 Z7 Dtreatment. Previous reports of patients stopping treatment in complete molecular* j; h) G8 I- A+ g5 Z: `
response have included only patients with a good response to imatinib. We8 I: W2 k, h+ |- t1 h# e. ]$ a
describe three patients with stable complete molecular response on dasatinib
5 F7 y! D: k- ~8 I0 htreatment following imatinib failure. Two of the three patients remain in, c& V, J" a! }* G) I. A# ~
complete molecular response more than 12 months after stopping dasatinib. In
" W4 N, v0 T. b% o: }3 E3 rthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
- T2 T: W% N6 I! [: m mshow that the leukemic clone remains detectable, as we have previously shown in
2 [3 N5 `) z8 k; Timatinib-treated patients. Dasatinib-associated immunological phenomena, such as
p9 [+ e& h4 D) }: G2 B- _9 Jthe emergence of clonal T cell populations, were observed both in one patient- U+ @# J" p6 q" A+ u
who relapsed and in one patient in remission. Our results suggest that the
9 n, T. L& ^ X9 O, o, b$ Z, Ucharacteristics of complete molecular response on dasatinib treatment may be
: v2 S5 I+ o6 |similar to that achieved with imatinib, at least in patients with adverse
8 s% |: _5 {& {! n" wdisease features.
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