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
7 G) ]. T, {! W; _来源：Haematologica. 2011.8.9.
Dear Group,
; j2 g, @1 ]& U2 J
8 X! l+ v0 ?+ e3 m+ ]3 uSome 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
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
does spike up the immune system so I hope more reports come out on this issue.
% S5 v9 z- Z4 f
The remarkable news about Sprycel cessation is that all 3 patients had failed
' r$ H! f4 W( S& O5 eGleevec and Sprycel was their second TKI so they had resistant disease. This is
different from the stopping Gleevec trial in France which only targets patients
& X1 O$ P9 d: Y, ywho have done well on Gleevec.

: ~! ?0 v& @, c- l% C: k# v5 DHopefully, the doctors will report on a larger study and long-term to see if the
  f" D9 R* Y7 Tresponse off Sprycel is sustained.
2 K6 N$ y: |6 c. V4 @1 k
Best Wishes,
Anjana
+ M$ r7 {* q, @/ C, Q( J  |


9 c2 W" j- B+ U+ @7 b6 ?1 BHaematologica. 2011 Aug 9. [Epub ahead of print]
0 |5 [9 y6 n7 u4 \7 ADurable 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.
( c7 C3 k7 i9 e8 s; _Source
7 |% r# q$ u9 PAdelaide, Australia;

7 G  e; B" |- L. Z& C8 |' MAbstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
" |  H8 }; t6 L% n+ J" |response have included only patients with a good response to imatinib. We
9 O8 b" @) c  ydescribe three patients with stable complete molecular response on dasatinib
* X. b8 c  p( P% Utreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
show that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
+ \2 M9 _( n! `$ S  fwho relapsed and in one patient in remission. Our results suggest that the
+ j7 r4 e3 x# Z  Hcharacteristics of complete molecular response on dasatinib treatment may be
; e9 ]3 a' Z) t) ]$ w' Z: dsimilar to that achieved with imatinib, at least in patients with adverse
disease 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。
    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。
1 O# K) `' U, I2 ?) Q% v6 C    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。
! r/ O) U1 c5 w4 I4 I' |
; `4 r) z- I: F, a7 V作者：来自法国STIM试验
; K5 N& X! S2 b7 T9 c; ^( a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