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。
( G/ R# ]" B( h* I Y: | 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。
# |+ |1 A1 C; k
& H' T9 j2 o+ r( C" B作者:来自澳大利亚$ e( J3 F- d6 g% o# L S9 x! C- {
来源:Haematologica. 2011.8.9.
, C4 J3 q5 y& Z8 }4 TDear Group,
4 }# H$ A: l/ A( k6 I
4 r6 N W! l. x& G1 i/ R* FSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML/ n4 h" Q( B ?
therapies. Here is a report from Australia on 3 patients who went off Sprycel3 i0 Z1 E1 a# l2 [/ z. R" t
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
# @4 y3 W+ L& }& O$ Q; K0 H3 y8 |8 qremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel/ u& v, {( N7 p7 }; C
does spike up the immune system so I hope more reports come out on this issue.. a# F& _; Z4 K6 ]
7 l# A; C7 T/ {2 r u( h) K
The remarkable news about Sprycel cessation is that all 3 patients had failed
! y0 P6 \8 ~5 m8 D) \0 PGleevec and Sprycel was their second TKI so they had resistant disease. This is/ V6 n' b5 ^& E. J$ z
different from the stopping Gleevec trial in France which only targets patients3 z$ i2 ~) X0 p6 {+ t
who have done well on Gleevec.
4 z- B a; r, A
& t8 Z8 y# B; R, D9 IHopefully, the doctors will report on a larger study and long-term to see if the
' p; v: D5 \4 B! l$ p6 k l, Mresponse off Sprycel is sustained.
$ Z; K9 Q+ I; F1 c# u
/ \5 E: z' N% P* u5 mBest Wishes,! q; Q- ?) t: k% y# M5 G
Anjana
U I5 _4 |9 X: Q8 q
] j$ O# t& A Z8 ^
8 C: v' { Z5 J m; x# T. g
: f1 s; u, c7 m$ gHaematologica. 2011 Aug 9. [Epub ahead of print]5 ?8 T4 L+ j7 h- |. f
Durable complete molecular remission of chronic myeloid leukemia following
$ S- x- Y3 c+ k5 k7 h+ }# `& d/ {dasatinib cessation, despite adverse disease features.
3 B" r" u! l+ X/ Y; q. kRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
3 |; A% W p8 V: Q3 uSource
) ]/ p6 t1 }8 ~8 B4 C2 bAdelaide, Australia;8 }7 V( |: s1 L- |6 p5 Z4 n* y
/ x+ c! o" x7 ^2 e
Abstract4 s3 k' y; h- r3 T
Patients with chronic myeloid leukemia, treated with imatinib, who have a
; T0 V( Q: \0 T; \durable complete molecular response might remain in CMR after stopping
1 X( X9 [4 [7 D I6 Ptreatment. Previous reports of patients stopping treatment in complete molecular
* P+ M9 i! v4 s+ M# Tresponse have included only patients with a good response to imatinib. We
# X9 s$ [9 p8 _; X" n/ H5 Ldescribe three patients with stable complete molecular response on dasatinib4 F' Q* I; {" ?' D: T) h1 ?
treatment following imatinib failure. Two of the three patients remain in8 f# c t9 k! C) B
complete molecular response more than 12 months after stopping dasatinib. In; |9 B5 R1 d7 e# |8 U
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
' s( T/ `3 Q$ p% X( _- t. s2 q" Wshow that the leukemic clone remains detectable, as we have previously shown in7 R! ~9 a) h) a* P2 \
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as% Y- v/ u% P, O N) k( S, J
the emergence of clonal T cell populations, were observed both in one patient
9 k. c& W" [1 H& ^4 [( owho relapsed and in one patient in remission. Our results suggest that the
, h$ c; m7 t: h" V9 V1 w/ ^9 Fcharacteristics of complete molecular response on dasatinib treatment may be- x, w; H, o% M) d
similar to that achieved with imatinib, at least in patients with adverse8 z' v" {& {! Q( v
disease features.
" o8 a8 Z x1 \. s3 a/ P |