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。! ]6 p( F0 p8 b8 c" w( }8 D. U6 k) J
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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; r- u; f% \3 d9 z" B `作者:来自澳大利亚$ [# t* j+ x( _: a
来源:Haematologica. 2011.8.9.
# X5 X7 \3 b- _& TDear Group,7 w5 w& n# W4 N5 y9 z
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
' k8 d1 j: K) e5 |7 a! g) Ttherapies. Here is a report from Australia on 3 patients who went off Sprycel
' S) `* S1 x& Z6 N; qafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
# x/ I- ?% x4 b5 S# x: t* Wremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
$ O# r- e6 t& }2 gdoes spike up the immune system so I hope more reports come out on this issue.
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The remarkable news about Sprycel cessation is that all 3 patients had failed4 a* d2 ]$ `+ Z( a
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
, b, T6 B$ x$ f& Q, B% o9 T2 N& I. Rdifferent from the stopping Gleevec trial in France which only targets patients# j! [8 k, j) _2 q6 X( o
who have done well on Gleevec.
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$ P8 o3 M6 a, }+ ]Hopefully, the doctors will report on a larger study and long-term to see if the) C# v7 P, L( b5 a3 B( o
response off Sprycel is sustained.: ^6 Y0 \$ L% |( [ ~
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Best Wishes,( b+ }( H- ^' P; n
Anjana
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/ K# m2 E, o; Z6 PHaematologica. 2011 Aug 9. [Epub ahead of print]
b! F0 _& @& X& ~3 ?$ _8 mDurable complete molecular remission of chronic myeloid leukemia following, ^% @; o* X7 p0 s; m& ]
dasatinib cessation, despite adverse disease features.
6 |# v' G+ @$ k/ @9 g4 YRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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Adelaide, Australia;
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Abstract% Z) x+ U6 M# F1 e
Patients with chronic myeloid leukemia, treated with imatinib, who have a
4 Y& I/ h: X: j7 Cdurable complete molecular response might remain in CMR after stopping
' F! T/ k2 Q! {2 rtreatment. Previous reports of patients stopping treatment in complete molecular; x& M, c/ m6 o) Y0 r/ S0 o
response have included only patients with a good response to imatinib. We) d7 ^/ e. U9 l+ d
describe three patients with stable complete molecular response on dasatinib
7 C* ^: ]( g) Y( g) ktreatment following imatinib failure. Two of the three patients remain in% U7 m! l+ ]' k2 C9 v
complete molecular response more than 12 months after stopping dasatinib. In
2 k/ c7 l" y2 T: k# M5 ? pthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to) h/ X4 `' F! D# W# l7 p e
show that the leukemic clone remains detectable, as we have previously shown in) P) ~& h# m, o* P
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as* O# E. P6 L' D _
the emergence of clonal T cell populations, were observed both in one patient% A/ ~) q4 W2 {# A3 i0 f# m5 s) o
who relapsed and in one patient in remission. Our results suggest that the! W- t( |; n) }; e) z
characteristics of complete molecular response on dasatinib treatment may be; D& Q4 L( |! f Y
similar to that achieved with imatinib, at least in patients with adverse/ j9 c4 f2 S" r+ L2 u4 S
disease features.
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