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。
! W# r9 O, I1 |% 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。' g/ z1 e% O6 j$ ~% P
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作者:来自澳大利亚. o1 I a) ^/ ?) i$ |3 k
来源:Haematologica. 2011.8.9. J% c3 o4 L3 N6 G
Dear Group,3 V7 `4 H& g2 V
4 A' ?( ^0 E/ g, ?8 d! s0 M+ A
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML0 F7 v) _4 J4 D Q
therapies. Here is a report from Australia on 3 patients who went off Sprycel f% P5 n: s& S
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients3 n! |% r' A+ y5 T5 t- x; |
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel5 @2 u" z% e: I9 H4 j2 e' G! J0 k
does spike up the immune system so I hope more reports come out on this issue.
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4 B. S* o# g( A4 G! }The remarkable news about Sprycel cessation is that all 3 patients had failed) G. k2 \) O9 j6 w# g' m
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
2 V+ R2 M) ^3 i Gdifferent from the stopping Gleevec trial in France which only targets patients
. ~5 V$ L7 y4 I- r8 o z0 [3 kwho have done well on Gleevec." p" ?1 U, @: m" i& N* f: ~
1 d3 N. x; e1 aHopefully, the doctors will report on a larger study and long-term to see if the6 S+ J) D$ n$ R# V& r) k' P1 @/ |
response off Sprycel is sustained., u7 T* ~- {! P a* z0 x
' J7 n( J8 B- lBest Wishes,
, ]# R. e% c* S# H/ [Anjana
p% x2 A0 |: `5 y6 B) u; y( z! F0 n' h
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3 N" w! m; A! ~. f) I0 f0 X
Haematologica. 2011 Aug 9. [Epub ahead of print]/ D7 v7 z7 ]9 Z" V% ~0 Z9 E' I
Durable complete molecular remission of chronic myeloid leukemia following: u% p9 h/ r( Y- K+ @( T8 o& T
dasatinib cessation, despite adverse disease features.2 {3 T) R& x8 [# m. M+ X7 } ^1 T
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.- X+ b. g' T( `$ @* A- j" y D
Source
0 ~1 L; w! e" H7 Y% B' Q6 @Adelaide, Australia;4 \+ j6 N. G0 J, O
' [/ w) L9 f/ X4 p7 TAbstract
3 v6 H" U: B$ q5 oPatients with chronic myeloid leukemia, treated with imatinib, who have a
) |) J/ r+ J) t; t$ |% {0 P wdurable complete molecular response might remain in CMR after stopping
) Z6 V: k8 f$ T( i( B' t0 b2 ctreatment. Previous reports of patients stopping treatment in complete molecular8 j& O* u# V9 R* T5 G2 ?& ^
response have included only patients with a good response to imatinib. We* K2 Y5 Y' u! i! R/ O( F
describe three patients with stable complete molecular response on dasatinib. A. t1 {* } \4 s, t' E3 M1 g
treatment following imatinib failure. Two of the three patients remain in- N% V3 i; k7 |% h E& p. L
complete molecular response more than 12 months after stopping dasatinib. In
- E! Q; z! d R8 Kthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to7 a$ A$ e4 B- \3 A
show that the leukemic clone remains detectable, as we have previously shown in
\" K8 u, `- wimatinib-treated patients. Dasatinib-associated immunological phenomena, such as+ `" I4 F% p# V# _
the emergence of clonal T cell populations, were observed both in one patient. l1 d! B- {6 j% ]( o$ i }+ y% @
who relapsed and in one patient in remission. Our results suggest that the5 s/ r. v# H! \; I
characteristics of complete molecular response on dasatinib treatment may be) u/ {0 c4 ^' C) p3 r
similar to that achieved with imatinib, at least in patients with adverse# p" C$ N* R8 [% J
disease features.; Q8 v- P1 h4 y" p. d; \4 g
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