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。
8 R6 V2 y6 y6 u( Q    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 w- l& R7 v+ z! O作者：来自澳大利亚
* a) g+ c- f% m来源：Haematologica. 2011.8.9.
Dear Group,
$ C( J9 Q6 f6 _8 v# k9 F2 X* o
3 _/ V$ N6 e5 u( cSome 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
  F& L% Z2 r) H1 T/ W6 y; D- Xafter 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
, V) C* v- y' v' O8 Ndoes spike up the immune system so I hope more reports come out on this issue.
4 M5 q$ i; w2 H! h4 d
The remarkable news about Sprycel cessation is that all 3 patients had failed
+ o4 z% X8 d# {+ |1 h. D5 w9 AGleevec and Sprycel was their second TKI so they had resistant disease. This is
( ~7 ]2 l  a7 T' tdifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.

Hopefully, the doctors will report on a larger study and long-term to see if the
& h7 y2 l" T% N" t, z- kresponse off Sprycel is sustained.

- D" D0 [# a2 D4 n1 }( W- IBest Wishes,
% F5 d) E. {4 F+ m# |( X% UAnjana



! L" N' {7 f+ ^! e8 G! }Haematologica. 2011 Aug 9. [Epub ahead of print]
& o& s( D% p3 z0 V) W4 cDurable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
- C' [9 I7 a/ q6 `% ?, v% `, [Source
% n8 J/ A4 Z" s6 ]- Q* H7 V; S7 W  gAdelaide, Australia;

( [/ g: @; M* q" {5 WAbstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
9 t' m, N5 X5 z# e: {0 E; k4 vtreatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
* e' e3 x& ?2 Ttreatment following imatinib failure. Two of the three patients remain in
: \8 N6 c  t+ T2 m5 |  N% Q# u' r# u( Ocomplete molecular response more than 12 months after stopping dasatinib. In
0 r( F$ K  O% x6 X' l$ Q6 J3 g* zthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
+ d# H) Z+ W0 E- `  s9 v6 \show that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
6 X& ~; R6 y+ Q" K' k0 G6 tthe emergence of clonal T cell populations, were observed both in one patient
9 M! c$ |8 M" I- I3 Twho relapsed and in one patient in remission. Our results suggest that the
characteristics of complete molecular response on dasatinib treatment may be
! Q; r2 W4 l$ V$ ysimilar to that achieved with imatinib, at least in patients with adverse
+ ], A6 c, I: r, Qdisease features.
+ C5 u# D; V4 [- ~$ n9 L4 s

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- m  o6 b. L( {    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。

2 n# w+ l& K3 a( j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