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。% s& w5 w" i' i1 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。
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! t5 I5 r+ C4 p4 @% }作者：来自澳大利亚5 Z& W8 s3 v6 n. e' M
来源：Haematologica. 2011.8.9.
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML6 v) p2 E5 v) X" ?/ B. b5 ]
therapies. Here is a report from Australia on 3 patients who went off Sprycel7 X. i+ g! P ?* L
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
" x/ C3 K8 x* T* A( ]remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel3 g0 l+ S- Y$ b* Y% W
does spike up the immune system so I hope more reports come out on this issue.! _( K' p% R! j2 ^* v Y( _5 ^0 b
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The remarkable news about Sprycel cessation is that all 3 patients had failed
+ I7 W. e2 w- u# m+ l( c2 N ]2 XGleevec and Sprycel was their second TKI so they had resistant disease. This is+ L1 V& c/ o- w) x7 \
different from the stopping Gleevec trial in France which only targets patients3 @3 |! K. q V- z( k7 K; b
who have done well on Gleevec.
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( G7 \* [% t3 D! X7 D" mHopefully, the doctors will report on a larger study and long-term to see if the
1 p& e; W5 G. \: R9 l3 bresponse off Sprycel is sustained.
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7 }6 H8 h( d' w% r; x* N3 DBest Wishes,2 ?& R1 B2 E& s3 ^$ V0 {9 t, W
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
2 b0 o, [9 N* KDurable complete molecular remission of chronic myeloid leukemia following \$ K& ~# t$ [+ R3 N ~9 K Q
dasatinib cessation, despite adverse disease features.) ?. s4 x# B5 u% [: x
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.2 `. t" r4 S" D
Source
9 T5 m' n8 c# s/ A) XAdelaide, Australia;
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% n3 [1 G/ s: \6 oAbstract
* ^" I" A2 W7 V; _6 zPatients with chronic myeloid leukemia, treated with imatinib, who have a* C& y, i7 ?# w. K) j0 Q# T" V
durable complete molecular response might remain in CMR after stopping0 f4 C* z* O9 u9 p
treatment. Previous reports of patients stopping treatment in complete molecular+ X5 I: V4 F8 A% h0 c% F$ i9 t
response have included only patients with a good response to imatinib. We
; N* M* Y; M9 u" Xdescribe three patients with stable complete molecular response on dasatinib
- }8 E& D7 I; [treatment following imatinib failure. Two of the three patients remain in) E! K' a3 V' e1 j& a# H
complete molecular response more than 12 months after stopping dasatinib. In9 p0 k* v. k$ `9 E/ ^
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to, r% k) B4 ?" G
show that the leukemic clone remains detectable, as we have previously shown in
$ D' f4 t5 H9 T$ S; W$ K9 L6 Ximatinib-treated patients. Dasatinib-associated immunological phenomena, such as
- f3 O( w5 J8 g4 Sthe emergence of clonal T cell populations, were observed both in one patient
2 y9 p7 Q3 z/ N zwho relapsed and in one patient in remission. Our results suggest that the$ ^- @. a. d1 `2 ~/ J& g' q, L7 I u4 y9 m
characteristics of complete molecular response on dasatinib treatment may be
4 s; A6 j; M3 V P, W' _similar to that achieved with imatinib, at least in patients with adverse# x7 {' d9 t2 X! M' M
disease features.
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