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。
( L2 o& Q- Q$ x! H/ I+ F, y 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。 M0 ~; Q' `( ]- v J* I) E7 k3 W
$ f0 X1 L% g" D, \- p作者：来自澳大利亚6 S* [+ G+ H+ o. W9 {0 a3 U
来源：Haematologica. 2011.8.9.
2 {. O2 e' U; y1 w- l1 i i% ]0 hDear Group,, Q" d, f# R/ Z f* a) T; A
5 Q# D2 y# m, f* a6 [4 o9 Q4 pSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
6 k1 D. S, l; ^$ btherapies. Here is a report from Australia on 3 patients who went off Sprycel8 }' x% L6 `- f5 J& ~
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
* F( y: L, B* V: Nremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
, _7 r( K [: k3 r& u1 {+ ?- Adoes spike up the immune system so I hope more reports come out on this issue.' K6 X3 o8 N3 I! C4 o
0 s2 \. C7 o! i" pThe remarkable news about Sprycel cessation is that all 3 patients had failed
7 K+ s! B; _- U" H8 t4 F9 ]Gleevec and Sprycel was their second TKI so they had resistant disease. This is
. t& ]) c5 a# _different from the stopping Gleevec trial in France which only targets patients* j9 C4 P8 ?( M
who have done well on Gleevec.
2 a% f( k J# D
K7 i. p$ Q* o6 IHopefully, the doctors will report on a larger study and long-term to see if the
r6 L6 `, h% _; ~response off Sprycel is sustained.
& V* a/ J3 o6 h1 o# w# {8 R6 p1 \/ F: D+ \3 l0 }
Best Wishes,
/ h9 X, H$ D9 C. OAnjana
" [. M, z0 T$ u7 o0 B; g( }9 N( ~" @9 B
8 O0 m1 l% q5 j, F7 |7 m" k' |# f1 U
& k0 F. I k# B; H& dHaematologica. 2011 Aug 9. [Epub ahead of print]; Y& A0 N* G8 }
Durable complete molecular remission of chronic myeloid leukemia following7 P, \. ~) d/ s# n
dasatinib cessation, despite adverse disease features.0 {. Z0 I: \- q6 q( ], z5 q
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.0 }' y, p! |1 \
Source6 {# F9 M. o" n
Adelaide, Australia;# y! ]3 Y( Z' a5 |5 V
1 s9 N5 h) m7 u
Abstract
3 l; S. @' [: U$ ]& wPatients with chronic myeloid leukemia, treated with imatinib, who have a# L2 K9 `& b4 O
durable complete molecular response might remain in CMR after stopping) t; A; A5 ]8 ~ u8 u5 H
treatment. Previous reports of patients stopping treatment in complete molecular
8 S7 u2 @9 T u c" s$ g2 v8 p: cresponse have included only patients with a good response to imatinib. We Z2 @! G8 E" i& C3 n ~
describe three patients with stable complete molecular response on dasatinib
8 i/ I0 H. h! j l% v @! _0 btreatment following imatinib failure. Two of the three patients remain in: r" o6 Q) G F/ `6 `. ^$ Q
complete molecular response more than 12 months after stopping dasatinib. In2 y, O. T8 t& C0 Z& m; ?/ j
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to6 M1 t' Q5 ]7 Y
show that the leukemic clone remains detectable, as we have previously shown in' w- `, B$ u: o+ ]
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as* \' p/ a/ Q0 ]% } r' f
the emergence of clonal T cell populations, were observed both in one patient8 i1 i7 s$ j$ z
who relapsed and in one patient in remission. Our results suggest that the
: Y' ?" Y1 P% }. `characteristics of complete molecular response on dasatinib treatment may be
" h/ c7 i+ k. Fsimilar to that achieved with imatinib, at least in patients with adverse# d9 J0 [3 P0 j _2 j
disease features.; F" b* Y+ v3 T A
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