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。- I8 m4 {/ U( 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。6 f% w! C! P8 i% r5 A! M
* q4 A- M6 P4 Y) n* R. }+ ?2 C1 z作者:来自澳大利亚; Z; [$ {$ I. R6 a: @
来源:Haematologica. 2011.8.9.
; ?% r+ z! Q% F; Q; BDear Group,% f$ j6 W) z3 d. ?; |% x }; i
4 T- g8 r! h" P* J9 iSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
3 C% }1 X! G- S! E3 Q* Itherapies. Here is a report from Australia on 3 patients who went off Sprycel9 c6 H9 G, t5 f
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
! C% `& d/ I/ B; z- Z9 }remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel* w, @8 V9 b6 g7 v
does spike up the immune system so I hope more reports come out on this issue.
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) R1 E B* [7 wThe remarkable news about Sprycel cessation is that all 3 patients had failed
d& ?8 \* N9 i/ y8 I! `" EGleevec and Sprycel was their second TKI so they had resistant disease. This is4 G/ s; ?+ }! B
different from the stopping Gleevec trial in France which only targets patients1 x# u# b3 W- O, T3 k
who have done well on Gleevec.- x0 O) |- a/ C! \5 Z6 e
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Hopefully, the doctors will report on a larger study and long-term to see if the
9 x4 U4 u* U3 ?: {* \, U1 Q9 Fresponse off Sprycel is sustained.' B9 }- B; b" _6 \% @
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Best Wishes,
* _/ `2 H7 G/ H& a! ^3 Q4 F9 cAnjana
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! P9 Y" Y2 [4 I) F( k! `Haematologica. 2011 Aug 9. [Epub ahead of print]* F7 P/ f8 v- C* [" T
Durable complete molecular remission of chronic myeloid leukemia following
) K; r% ^) }9 m3 n% L% edasatinib cessation, despite adverse disease features.4 R Q& B1 e2 o0 R$ m# Q6 o9 w
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.8 q6 j# T' k- ?+ k8 V
Source
; P7 \: a! E# ?6 e$ ]8 R& c+ NAdelaide, Australia;
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Abstract' |. n2 S5 W* [9 H9 g% I! k+ T
Patients with chronic myeloid leukemia, treated with imatinib, who have a* ~) z9 P1 ]0 l- H2 T' O4 C& M' G
durable complete molecular response might remain in CMR after stopping
- X( P6 Q/ A+ ?3 v- y B7 ptreatment. Previous reports of patients stopping treatment in complete molecular, T l1 y% d7 x
response have included only patients with a good response to imatinib. We
) a1 _5 {3 n% f3 `4 I% Hdescribe three patients with stable complete molecular response on dasatinib* s& G" q u1 _" B* x+ K1 r6 x
treatment following imatinib failure. Two of the three patients remain in
2 c2 d3 n9 ~* _$ T* acomplete molecular response more than 12 months after stopping dasatinib. In" b, B5 q, Q7 G$ \+ _" U
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
, H% y6 X! X( a4 }& r# n6 B+ i- Tshow that the leukemic clone remains detectable, as we have previously shown in
# p, G& R) {6 l$ E9 Yimatinib-treated patients. Dasatinib-associated immunological phenomena, such as9 v, v: F2 D0 _& I: W
the emergence of clonal T cell populations, were observed both in one patient: m" y3 E) I3 j
who relapsed and in one patient in remission. Our results suggest that the
/ s& e+ _6 e( n, echaracteristics of complete molecular response on dasatinib treatment may be+ m5 X& @$ i' v0 p
similar to that achieved with imatinib, at least in patients with adverse; W* _: c. h- D) V1 k( z
disease features.
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