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。
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作者：来自澳大利亚
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
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
# |: E. `6 p3 S; ]" xdoes spike up the immune system so I hope more reports come out on this issue.

# 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
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.

7 c) J# H, P- z4 p8 f1 EHopefully, the doctors will report on a larger study and long-term to see if the
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


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Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
/ R1 {2 x) s$ U& `. Z# WRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
5 }, i. {2 _* g# f, [# gSource
Adelaide, Australia;
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. b) E% ?. D8 S5 s2 |+ r/ `2 lAbstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
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
response have included only patients with a good response to imatinib. We
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
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
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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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。
6 l* m* `/ W3 E& R% |( a    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。
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- G% m3 `5 W) 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