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。
) r: N; n# ~. K 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。: Q* R; L; e1 @! M: J/ K
5 d9 S8 _4 b% j. V7 f6 Q/ j( _# S4 k a作者:来自澳大利亚$ Y* C3 K- P- b% c
来源:Haematologica. 2011.8.9.
2 {* _$ Y: j2 u* I- p, XDear Group,) p" e, ^) a, O( H {, ~5 G f6 e
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML: E+ Y% a, W, l X+ {' e' C4 \
therapies. Here is a report from Australia on 3 patients who went off Sprycel
) _7 N4 \0 `$ u6 [, rafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
. n# A: y3 E) S, }7 \ W" Hremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
4 F7 B+ _2 m! c2 Z5 _( Odoes spike up the immune system so I hope more reports come out on this issue.0 H& V, M# Q/ i% a0 V
# U$ m* K0 P- D6 k6 [4 a; }The remarkable news about Sprycel cessation is that all 3 patients had failed
) b0 T- H* }. a) x5 _6 e! CGleevec and Sprycel was their second TKI so they had resistant disease. This is! o6 D5 m6 W5 O L" A7 \: R
different from the stopping Gleevec trial in France which only targets patients
l1 y! o" c, z3 {- N) }& T4 hwho 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
7 e, D5 {8 X" ^' \1 Bresponse off Sprycel is sustained.* F9 A) K+ {8 j: o
- A7 k d+ T1 WBest Wishes,
2 Z% D8 T6 _2 DAnjana
5 \! B3 O7 v' E! \# A' ~
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6 i9 X& `9 t& n6 I3 [( EHaematologica. 2011 Aug 9. [Epub ahead of print]
( G3 _. \1 T6 C/ v: R+ G' X3 c2 UDurable complete molecular remission of chronic myeloid leukemia following
6 I+ E% k6 [. s2 g/ ], a# r# mdasatinib cessation, despite adverse disease features.+ x" q" F/ D# s% j8 a3 n& M& ?% g+ y
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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Adelaide, Australia;
3 n& _; A0 _ Z9 Z( v) p5 R1 J- I
Abstract2 Q O- [# S7 f4 Q
Patients with chronic myeloid leukemia, treated with imatinib, who have a U* g4 y$ L6 t8 g7 W
durable complete molecular response might remain in CMR after stopping3 c% F) Y, D$ H [: P& G% e
treatment. Previous reports of patients stopping treatment in complete molecular3 E" p- n( R4 ]* X* _6 }1 M
response have included only patients with a good response to imatinib. We# n: ^( `) O, a( d; p& O- v
describe three patients with stable complete molecular response on dasatinib
8 X# S% H& u& k# wtreatment following imatinib failure. Two of the three patients remain in& h# B+ n' D# I' B1 p" Q! s
complete molecular response more than 12 months after stopping dasatinib. In5 Q: e, J0 W$ Z0 x- Z: a
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to0 O6 s2 {# W6 V# `1 {# T' B$ @
show that the leukemic clone remains detectable, as we have previously shown in
3 x4 v! T/ y- `" ^) L( c* d. \imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
9 b y8 i" f/ j+ g k; D5 x" fthe emergence of clonal T cell populations, were observed both in one patient' c# ]- L; [( K6 c
who relapsed and in one patient in remission. Our results suggest that the# P: Y7 \9 C7 O6 J- i* X' i
characteristics of complete molecular response on dasatinib treatment may be
% e# J# b% ]8 y$ n0 w: \similar to that achieved with imatinib, at least in patients with adverse& W2 z3 ?- e5 l$ h% m
disease features.' {4 F9 O' o+ u$ C9 p- a6 }# U
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