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。
3 j' u; s% c5 r1 D 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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! |' D' w1 _. g8 ~9 y$ x/ i作者：来自澳大利亚
& Q7 G$ I- q5 |0 {, U! l来源：Haematologica. 2011.8.9.% H" O) y- b$ p9 z/ X2 U
Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
) {( t& V; K4 j, B5 ktherapies. Here is a report from Australia on 3 patients who went off Sprycel
/ y" H8 ]* m. |0 T; b H- O, hafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
0 I9 Z% w0 [/ i+ fremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
7 r' N: O5 [, W1 J/ V$ r2 {1 Z8 Adoes spike up the immune system so I hope more reports come out on this issue.
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The remarkable news about Sprycel cessation is that all 3 patients had failed: m# ` l- L1 X3 [7 S
Gleevec and Sprycel was their second TKI so they had resistant disease. This is; D9 {( S {5 x
different from the stopping Gleevec trial in France which only targets patients* t. H; @; \* {9 @( ]& Q
who have done well on Gleevec.9 d: n* D- q" e9 u
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Hopefully, the doctors will report on a larger study and long-term to see if the
. V. N! | b, d, B: Kresponse off Sprycel is sustained.; l V( s) V# P! @5 n# k4 b
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Best Wishes,8 ]$ |" d& [, N. n9 G$ Z. y
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
4 X \" o. J% }& [Durable complete molecular remission of chronic myeloid leukemia following
8 j0 B# X) q; J2 o6 c8 j8 adasatinib cessation, despite adverse disease features.
& X# b6 _3 n# J4 h: H! e* U7 bRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP./ I, K, U! H0 g6 m, e' {( F) ~
Source
' Y1 N; ]+ }$ N3 jAdelaide, Australia;
6 H/ C! S+ E `# k; H) N( o( q. E/ E. h
Abstract0 S: f$ ? x4 v$ S. f* G
Patients with chronic myeloid leukemia, treated with imatinib, who have a
% K' o* U" D5 ]/ u$ M: i Wdurable complete molecular response might remain in CMR after stopping
$ h2 s0 u' T/ o j+ m$ \treatment. Previous reports of patients stopping treatment in complete molecular
. B" c5 l9 U8 R# iresponse have included only patients with a good response to imatinib. We
- j+ f E, o2 Fdescribe three patients with stable complete molecular response on dasatinib
7 o! a, F; L Rtreatment following imatinib failure. Two of the three patients remain in, b m$ I$ G8 d0 q8 `2 w
complete molecular response more than 12 months after stopping dasatinib. In
/ }0 X$ S7 M# p# p# U, hthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
: _3 i# f7 p# h, }show that the leukemic clone remains detectable, as we have previously shown in6 n2 ^; k# M: L
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
" ~. r% X# ~+ i, a* z- C' P1 P# Mthe emergence of clonal T cell populations, were observed both in one patient7 v5 Z# i2 r, f# g: @4 o' v
who relapsed and in one patient in remission. Our results suggest that the
+ U; z. }9 [! j2 X f0 ?- ?1 dcharacteristics of complete molecular response on dasatinib treatment may be
9 m0 w, o8 E' K) k; K- j' {. ssimilar to that achieved with imatinib, at least in patients with adverse
+ a# D% r7 X* T) sdisease features. j& _& ~5 A& a8 }3 D
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