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。8 ?( K! W. \. M" ~2 G l- Q5 m
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。; J0 Q& F9 l; M% ~' o
. b& ~9 j; S6 N( E% n4 A作者：来自澳大利亚
4 S: ` v, b0 w来源：Haematologica. 2011.8.9.
$ H" V' @. g6 f) M; |. SDear Group,
& h2 G8 a8 V5 l& r% Z; X3 B4 T# T
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML# v$ A$ a% C4 o# [6 i" r3 ^
therapies. Here is a report from Australia on 3 patients who went off Sprycel0 Q2 }/ }: l* T& K
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
( w0 T7 R1 Q9 ^1 Bremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
- L6 ]1 a& s6 F: m8 I0 s+ Pdoes spike up the immune system so I hope more reports come out on this issue.% t" {0 [" ^' Z; T( d- {
, e: d; G( i5 G. sThe remarkable news about Sprycel cessation is that all 3 patients had failed; R4 T" t% o7 b( x. a* R
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
. x' K- V- @$ J2 h( Q4 {9 \% m: P2 edifferent from the stopping Gleevec trial in France which only targets patients
/ |' L) N9 Y( r; T9 {who have done well on Gleevec.3 { H; Y. I$ M, m g
/ S3 I/ }. `0 k0 ]Hopefully, the doctors will report on a larger study and long-term to see if the
2 z! P$ C8 [: T# ^) _4 B# ^- presponse off Sprycel is sustained.3 x8 }. h# X3 Y3 _2 H, K
3 l* `8 d7 v; A
Best Wishes,' s' ^8 t: x8 I$ h$ j
Anjana
" }1 ^' S& W' \9 l3 {4 _2 e! F; Z; |4 {
$ x" Y( b; _; L: a3 P2 P. A
* ~6 ]. ^. v/ Q+ S' gHaematologica. 2011 Aug 9. [Epub ahead of print]
' g5 W0 P. ]. w4 @; l# ^1 }' L- sDurable complete molecular remission of chronic myeloid leukemia following
! j4 Q. ^" i' B* v+ G% r" |3 Mdasatinib cessation, despite adverse disease features.
$ p2 I; P$ ^+ V8 @5 y0 zRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.8 ]0 a6 m g; W
Source
9 B% M7 {, P9 u! B; a. i/ bAdelaide, Australia;
) h& P) x' B4 ]! y/ b* U8 S( ]
/ l' Z4 Z/ N1 M. Q- n) U" _$ _Abstract
6 I1 v" ]" i- ?6 o; NPatients with chronic myeloid leukemia, treated with imatinib, who have a
* Q2 J4 c1 K* Y# x* t# `( udurable complete molecular response might remain in CMR after stopping/ o# j8 L+ t0 S# ]- ?
treatment. Previous reports of patients stopping treatment in complete molecular
+ X8 h( `% H7 y% b0 bresponse have included only patients with a good response to imatinib. We
! o+ x& ?! S, ^: L! adescribe three patients with stable complete molecular response on dasatinib' R1 G# h; M! H, R7 G2 n
treatment following imatinib failure. Two of the three patients remain in
4 a# {) k( r" B5 F9 M2 ecomplete molecular response more than 12 months after stopping dasatinib. In
6 B" }( M. `1 C2 ythese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to! ~5 B' S% N' O, P8 ~) A1 K) ?
show that the leukemic clone remains detectable, as we have previously shown in# `3 N3 w1 Z6 f( Y4 \" v U
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as6 i+ V% r* N) V( j, S. t8 v: x
the emergence of clonal T cell populations, were observed both in one patient3 K, h) t8 t1 a7 a& s; M% R7 s( g
who relapsed and in one patient in remission. Our results suggest that the
- u) l( g8 N6 i# rcharacteristics of complete molecular response on dasatinib treatment may be: l$ d# C* p0 A/ u. ~$ U
similar to that achieved with imatinib, at least in patients with adverse
0 ?1 W% }! e6 d4 A7 S4 R" s( L( ldisease features.: b) p- k$ q- a* |/ P2 d( t
|
显身卡
