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。
. T+ i. _! @: y0 _8 h8 c 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。- W' x: g3 ?' d) ]$ |
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作者：来自澳大利亚
3 E8 i/ }" k# r7 s0 N4 C7 I来源：Haematologica. 2011.8.9.% l8 u* ]4 H) s6 g' w! T
Dear Group,
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8 A7 h5 ^: v) { Y% \9 U9 \Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML) G! n" t6 Z4 s, l$ u
therapies. Here is a report from Australia on 3 patients who went off Sprycel
( f4 I `# Y1 e& J2 R) |2 zafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
4 b2 g3 ]/ X0 Q+ {, ]remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel& l0 S8 C6 |( K9 g
does spike up the immune system so I hope more reports come out on this issue.0 P0 c5 c. F. L+ x0 Y t4 h5 q
; y0 G6 F' s/ G% m6 n2 L: ^The remarkable news about Sprycel cessation is that all 3 patients had failed
) p9 w, ]6 d5 h* K4 w+ KGleevec and Sprycel was their second TKI so they had resistant disease. This is7 d0 X1 i1 B& b F2 P8 {
different from the stopping Gleevec trial in France which only targets patients: k0 ^4 O0 Q2 h: P7 Q9 Y3 e2 d2 Q
who have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the
, v. y" t. x! d2 j: X* R; Oresponse off Sprycel is sustained.
7 y; G/ ^% M! C4 A; N& v9 K- n/ A4 q- V6 [$ V2 f' P- J! `
Best Wishes,
- Y+ g: F$ b, G1 \6 I8 {Anjana, ^) J. p" h5 v6 j! ^
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$ ^$ _1 F( o8 Z0 Z9 B" c. e7 n2 `Haematologica. 2011 Aug 9. [Epub ahead of print]4 F7 w$ d4 {* a& n( d: j- Y
Durable complete molecular remission of chronic myeloid leukemia following0 j3 u1 Z( x# _
dasatinib cessation, despite adverse disease features.
2 Z5 H7 a$ r* R+ j9 WRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.) G1 C- [8 j1 t4 E1 ^$ |7 |
Source
$ T! B" b+ P% h2 M% Q: dAdelaide, Australia;! F" E! i8 I4 b& J
- M, R, u" E7 C2 ]# DAbstract# O, n0 X; h. N- j' `2 r/ }
Patients with chronic myeloid leukemia, treated with imatinib, who have a$ @# I: {2 ^: P' L6 L
durable complete molecular response might remain in CMR after stopping
- P' S$ U6 N" n0 |1 |0 V2 Jtreatment. Previous reports of patients stopping treatment in complete molecular
! t( L% g4 [# O6 bresponse have included only patients with a good response to imatinib. We* S+ Q4 |- l6 A1 S& u j
describe three patients with stable complete molecular response on dasatinib
# b# I( S1 t# j- x9 n6 Xtreatment following imatinib failure. Two of the three patients remain in
" H- S7 b; u5 y& Q0 V8 K( xcomplete molecular response more than 12 months after stopping dasatinib. In
; V- g# W1 f3 K5 {% ^these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
. R- o. V! m$ {' Ushow that the leukemic clone remains detectable, as we have previously shown in
" x# c! E; a9 U# l( Bimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
( {) ]/ ]! F7 H9 N0 y0 }3 \the emergence of clonal T cell populations, were observed both in one patient6 z: `# J) O9 ~+ i
who relapsed and in one patient in remission. Our results suggest that the
# b6 }! z8 R* P3 W# ?9 @! `$ l$ _2 F3 Wcharacteristics of complete molecular response on dasatinib treatment may be
0 h5 M" K' c' H/ Q F; Ksimilar to that achieved with imatinib, at least in patients with adverse
1 r, Z9 d- `9 O; @1 _disease features.; ~( d/ f& ^5 p. e$ T4 Y
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