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。
2 A5 H; \0 Y) B6 ~- N 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。
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作者:来自澳大利亚9 c" @; \ B$ E3 C0 j4 e
来源:Haematologica. 2011.8.9.
. J4 K0 Y6 [2 |8 eDear Group,
3 V- h7 ~. ]$ B: A, I; f
/ V; a% W: @8 z1 t3 d' FSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
& K( ^& A- ^1 y8 rtherapies. Here is a report from Australia on 3 patients who went off Sprycel8 p/ V2 s0 k( F8 U O
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients4 T8 @5 r) p% Z+ O; i' Z6 o- t: p) P
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel, j; x! l7 U9 G e' S+ U! q
does spike up the immune system so I hope more reports come out on this issue.
$ A/ D6 Y3 l* X
* r8 w/ R1 v3 e5 ?: nThe remarkable news about Sprycel cessation is that all 3 patients had failed2 ^9 M1 M2 q; s) i( p0 D1 _8 `
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
# p+ R y! S: g1 O1 s+ ~different from the stopping Gleevec trial in France which only targets patients
! A/ T7 W9 `! Z4 X# J" t% kwho have done well on Gleevec.
4 S, t: T/ m2 M# k* }8 Z7 _4 E+ j$ l1 B+ Z* u4 i
Hopefully, the doctors will report on a larger study and long-term to see if the. g. K# |3 d7 c6 h
response off Sprycel is sustained.
" U& o/ S* p) L* X
/ w% _$ K6 M- }Best Wishes,2 t. N. t; n# v! ?- w. ~/ F
Anjana
; F& Z& G) F0 e1 r3 o$ ?/ A! ?5 c, u: z# A! L0 t) j$ ?: M- I
" J) ^2 N) Y L2 e( y; K' Y
6 ~1 m9 j6 K. s6 e0 c M4 o; {8 bHaematologica. 2011 Aug 9. [Epub ahead of print]: w4 U1 ^8 A6 d
Durable complete molecular remission of chronic myeloid leukemia following
1 T% H* B- U# `" L+ Z; K. Tdasatinib cessation, despite adverse disease features.
# s) v l1 V: W! B5 f i' SRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.0 M1 \6 X* _ a* {! d1 T
Source z0 e9 E2 } j5 f
Adelaide, Australia;/ F8 |9 ~9 G$ m6 W p
0 o. x8 u, i3 O+ O! S
Abstract. c8 R0 K! `# _; C( K; [6 K) E# q
Patients with chronic myeloid leukemia, treated with imatinib, who have a
. z+ e- C6 F5 u' U9 F' edurable complete molecular response might remain in CMR after stopping
( K6 k* e, Q* l4 f/ Itreatment. Previous reports of patients stopping treatment in complete molecular
3 v1 @9 ?! I9 G7 S" \$ xresponse have included only patients with a good response to imatinib. We
& i' Y V) H% ?1 Fdescribe three patients with stable complete molecular response on dasatinib
9 G7 i: d8 T/ {; s, g& {+ m& ctreatment following imatinib failure. Two of the three patients remain in3 Y, l( n1 w, V4 @/ E* o
complete molecular response more than 12 months after stopping dasatinib. In6 ~! @, s: K8 W3 r W
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
, k& c( @! ^8 x$ f# |3 yshow that the leukemic clone remains detectable, as we have previously shown in
! a! N8 E/ i$ f# ^- W( kimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
4 t( E R. V7 ` I) Othe emergence of clonal T cell populations, were observed both in one patient5 U- ]3 @! s! @* P8 j, f1 p9 [/ p
who relapsed and in one patient in remission. Our results suggest that the X" A, l8 w/ _) V5 y; ?* j
characteristics of complete molecular response on dasatinib treatment may be
9 n' X/ m4 d4 O+ A- k$ X+ u; y3 Nsimilar to that achieved with imatinib, at least in patients with adverse. C: F& q$ E7 q3 q
disease features.5 e U6 K) U. |$ K6 E4 I
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