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。' A4 E# z( Y8 Y* A9 v
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。$ e2 r# T" y! O- L2 C, W% N5 p7 n
j8 I% H5 Q0 t$ U) \作者:来自澳大利亚! {4 }* a; Q/ Y p- q
来源:Haematologica. 2011.8.9.; Z$ K4 {3 C( z% k u5 t4 S9 Q
Dear Group,
3 a; N) V8 C$ P: n
+ |1 ^# F5 s8 @, h/ OSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML+ F$ U2 R: G7 [1 N: h5 e. e
therapies. Here is a report from Australia on 3 patients who went off Sprycel
9 L0 W, m$ o, K+ mafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients, m0 H& [( H' r* V. s& B3 n
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
$ C# @" h6 t& Ddoes spike up the immune system so I hope more reports come out on this issue.
/ t! v& r5 \5 y- C7 C/ l c; L" R$ X% Z& `/ ~6 Z# E* f
The remarkable news about Sprycel cessation is that all 3 patients had failed, a, L8 T7 G6 m% K( K
Gleevec and Sprycel was their second TKI so they had resistant disease. This is& Y2 F: ? I% V! C- d; T6 @
different from the stopping Gleevec trial in France which only targets patients$ M. x" }, s% f, i8 A9 q
who have done well on Gleevec.
) ]+ Y! h+ Z7 _! L4 [ Y& ?! k. T" G6 l: W+ @# Q
Hopefully, the doctors will report on a larger study and long-term to see if the" D3 D9 P) e: W# `0 s& s( C* r. t
response off Sprycel is sustained.
1 @6 t( t7 c$ k! G
. c# T$ W+ B6 M1 F& \Best Wishes,5 g- \6 g) S1 |" U" I
Anjana7 S: @, r3 U; a& W, Y
3 b* e& l3 b+ l# ]% a) m5 J- r1 @& `1 s* `, n5 Q8 Q
* @1 m E W5 G' tHaematologica. 2011 Aug 9. [Epub ahead of print]
+ P3 s: |# i1 B$ vDurable complete molecular remission of chronic myeloid leukemia following" _$ v: X: O( K7 S s! k
dasatinib cessation, despite adverse disease features. B( G9 W& m l2 X
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.+ t, }* l$ g. B8 r1 z
Source
$ y+ f( }4 h! y2 s% d9 MAdelaide, Australia;% b7 O6 ^) b3 ?. p$ F1 @( G
4 H3 b; N" C. y& E3 F8 t
Abstract
! ~! y' y/ i8 r# d2 KPatients with chronic myeloid leukemia, treated with imatinib, who have a
& N) T, P6 K# E+ L: [durable complete molecular response might remain in CMR after stopping
5 K+ l4 V7 U! K- y' w# Qtreatment. Previous reports of patients stopping treatment in complete molecular9 m. K7 j0 s; {% b7 `: ?
response have included only patients with a good response to imatinib. We
" G1 k7 w2 Z6 l Ddescribe three patients with stable complete molecular response on dasatinib
3 @' a- O2 _; ]5 Atreatment following imatinib failure. Two of the three patients remain in% k7 i% _/ z; T" {
complete molecular response more than 12 months after stopping dasatinib. In
7 s+ ]. N- M0 U; ~9 V1 Qthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to8 G: R8 n" F& L8 c) Y/ v5 M( v
show that the leukemic clone remains detectable, as we have previously shown in
0 N, i- v3 A5 E7 oimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
, @* o9 B) {& othe emergence of clonal T cell populations, were observed both in one patient5 S) V; q5 `, a9 ~3 x
who relapsed and in one patient in remission. Our results suggest that the
3 a: e' h& Z l5 U8 ~characteristics of complete molecular response on dasatinib treatment may be W/ @# g2 m! k
similar to that achieved with imatinib, at least in patients with adverse
2 ^5 g( h" K! ]( adisease features.
t" {, U0 N H( y: p6 m |