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。1 \' [( P3 i& X5 z5 e% q7 h
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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# O" ^3 _: ?2 H. l9 V# B% t作者：来自澳大利亚. R3 _7 I& C( w$ f/ A
来源：Haematologica. 2011.8.9.$ \9 X. f/ Z! v, x1 d, o
Dear Group,
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, E( R5 ^9 q% XSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
' k/ Z+ a7 m- `3 G' Ptherapies. Here is a report from Australia on 3 patients who went off Sprycel
5 h# j. ~' u- pafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients( a5 d6 R! d" c# v+ M
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
2 y; ]; u! f, N* rdoes spike up the immune system so I hope more reports come out on this issue./ P- Z; Z" v4 F7 f, ~
1 @6 ~; }, @! ^
The remarkable news about Sprycel cessation is that all 3 patients had failed8 L' c9 f% N$ n7 U# E( c
Gleevec and Sprycel was their second TKI so they had resistant disease. This is, B0 C2 R. u H. m( a. l
different from the stopping Gleevec trial in France which only targets patients9 y e) }$ U: @0 c
who have done well on Gleevec.( \9 U: x) a7 H$ O0 b
( E: t5 N: J6 c. E1 j- ~- v& QHopefully, the doctors will report on a larger study and long-term to see if the0 A- O' K# v- u) ~& e$ j7 Q" z
response off Sprycel is sustained.0 p/ Q2 }; c2 Q$ i# \" i7 Y
1 W) _$ H& V! s( cBest Wishes," l1 G" d) Y% Y0 H0 ~( v2 x: h: c
Anjana/ V! F' @2 u/ p5 B" G) L- A
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Haematologica. 2011 Aug 9. [Epub ahead of print]) T" [8 f |; R
Durable complete molecular remission of chronic myeloid leukemia following
3 _2 h: U, t. }6 _dasatinib cessation, despite adverse disease features.
5 c* I- t8 [, A; tRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.9 _0 o5 _/ m3 c2 c2 ~
Source+ x8 S# S+ z5 w4 @+ P! Y
Adelaide, Australia;7 p7 c0 W' j2 V; S( ]" m$ `; p
% W7 I5 v3 S0 ^% b& E0 pAbstract
" \: s9 _9 c' aPatients with chronic myeloid leukemia, treated with imatinib, who have a
1 ?8 z. l. _5 Ddurable complete molecular response might remain in CMR after stopping
" w9 {% e' G1 c: b: ~treatment. Previous reports of patients stopping treatment in complete molecular
9 k$ ?( h3 z! d! Q kresponse have included only patients with a good response to imatinib. We
: f+ M1 J" U; h2 Vdescribe three patients with stable complete molecular response on dasatinib, ]" Q* m, Z) j" ?! n
treatment following imatinib failure. Two of the three patients remain in
4 \. V/ [ T* }complete molecular response more than 12 months after stopping dasatinib. In$ j0 l( c! S p+ Y( P3 B9 k6 n
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to- x& ], U& `$ d, i( Y4 s3 o* ]: H
show that the leukemic clone remains detectable, as we have previously shown in
! T# k# K- [9 h8 h3 C Himatinib-treated patients. Dasatinib-associated immunological phenomena, such as+ j. i: Q2 j* {
the emergence of clonal T cell populations, were observed both in one patient
# i4 h* w0 F* g- y' R" }who relapsed and in one patient in remission. Our results suggest that the
- s- H* t8 H% \: T1 I# N* qcharacteristics of complete molecular response on dasatinib treatment may be% M4 E4 E. \+ J' }0 }! S
similar to that achieved with imatinib, at least in patients with adverse. ~' ?) |1 `) ^
disease features.6 ?. @9 L/ N4 D$ x1 ^# t
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