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 S% G0 g- ]/ z7 u 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。/ Y+ u2 p: U* A; T# _
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作者：来自澳大利亚* w$ Y$ `! D8 v
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 CML" ~) h8 }' n6 R6 p) l1 o( Q
therapies. Here is a report from Australia on 3 patients who went off Sprycel, l* m( N1 x" H8 v
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients2 v; o1 Q1 X% f& q; Z# c* a2 s
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
" `, Y, v6 B M+ S; U4 n2 |does spike up the immune system so I hope more reports come out on this issue.
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/ j5 A# ?. Q6 O7 [& w* sThe remarkable news about Sprycel cessation is that all 3 patients had failed
; c5 b" ^" i* I; AGleevec and Sprycel was their second TKI so they had resistant disease. This is. k: ^# o$ C) J" @) F
different from the stopping Gleevec trial in France which only targets patients! t2 R4 t- y; V! p; ?- P, [
who have done well on Gleevec.
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' q% @% C8 v* e3 w" i9 s+ YHopefully, the doctors will report on a larger study and long-term to see if the
G0 `5 b2 L j5 V+ A6 `' g+ T2 Cresponse off Sprycel is sustained.# E/ G. [9 e# H
7 U5 r- b& o6 J! ~5 V, l6 a9 v8 NBest Wishes,
. U* |* Y. w, `& DAnjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
" |3 C& d& O6 \3 p) a; [Durable complete molecular remission of chronic myeloid leukemia following: ~% n! G& h6 K! o; V0 L' q6 g% Z
dasatinib cessation, despite adverse disease features.) H, }/ a% C2 D$ s7 R% \9 A
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.! x5 f$ k3 @0 V
Source
5 o& F2 S2 D1 g. Q9 {0 W( hAdelaide, Australia;0 w5 s; }2 ?0 w8 G
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Abstract
& F: j4 P+ M% B* _Patients with chronic myeloid leukemia, treated with imatinib, who have a- D$ n/ Q' p) {
durable complete molecular response might remain in CMR after stopping
9 ]% j4 e; j# wtreatment. Previous reports of patients stopping treatment in complete molecular
( N/ u1 i2 c) }: n9 g$ H/ r1 M- `response have included only patients with a good response to imatinib. We
; ^+ m& D. E( A- r0 ]describe three patients with stable complete molecular response on dasatinib, C4 K0 ]( {% J+ _% E+ g
treatment following imatinib failure. Two of the three patients remain in
' O, w, D9 T& B/ \4 o' ?complete molecular response more than 12 months after stopping dasatinib. In n% w( N b/ `( Z: I' `/ [
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to3 v+ O- Q2 |' z! U
show that the leukemic clone remains detectable, as we have previously shown in
4 c2 n+ Z! v5 U k1 A1 zimatinib-treated patients. Dasatinib-associated immunological phenomena, such as& L" f; m) W. m* r
the emergence of clonal T cell populations, were observed both in one patient6 ]+ m8 v# s! S4 ?8 S
who relapsed and in one patient in remission. Our results suggest that the
* n% G$ P: ?+ S8 Y( Ucharacteristics of complete molecular response on dasatinib treatment may be
- a0 G0 x9 _5 Ysimilar to that achieved with imatinib, at least in patients with adverse" F7 E v6 g, ?+ ]- L8 ~% n+ t8 m# t
disease features.
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