关于停药的相关内容

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。
    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。

作者：来自澳大利亚
% e! [% E9 K$ [! i: l来源：Haematologica. 2011.8.9.
Dear Group,
  E& Q9 Z. n/ ^4 R* X: G
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
; B4 H7 L. W# H; z% \) U4 ttherapies. Here is a report from Australia on 3 patients who went off Sprycel
: N* T4 ]% @9 B) u! d5 x# dafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
: y1 y' G5 o* X1 ?remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
does spike up the immune system so I hope more reports come out on this issue.

The remarkable news about Sprycel cessation is that all 3 patients had failed
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
different from the stopping Gleevec trial in France which only targets patients
$ X$ ?* y* v" P6 V; cwho have done well on Gleevec.
# `7 n  ?$ X$ g2 @! @
4 S" ?. G2 J4 Q8 ~: T6 bHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

; \' ]1 p; J! n+ S/ q* V# r& I1 hBest Wishes,
Anjana

3 z$ a/ ]$ b$ B+ M8 j9 s5 [

! B& d. \. ^8 S% A& eHaematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
4 x4 w. q# K& Z$ l" @) Ndasatinib cessation, despite adverse disease features.
7 d: r1 C# [# I7 I! j  `! tRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
5 a$ {% G8 a2 B  B7 R  pSource
Adelaide, Australia;
- U! j* @0 B; a- e# n& M
* r0 x$ u+ V$ S; r7 s! O2 E1 S5 LAbstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
! L+ J5 E) |) n$ q4 `; j! xresponse have included only patients with a good response to imatinib. We
9 B, ~  V( J: x8 Ldescribe three patients with stable complete molecular response on dasatinib
! A, O  m- O! wtreatment following imatinib failure. Two of the three patients remain in
4 T5 F2 S% y1 G) vcomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
) C4 B0 n3 V+ Fshow that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
* f# |8 T: K0 h; o1 g3 ~) [' ?who relapsed and in one patient in remission. Our results suggest that the
characteristics of complete molecular response on dasatinib treatment may be
  `7 O3 i0 \* z/ r8 V% y# L. qsimilar to that achieved with imatinib, at least in patients with adverse
" W, v; m0 m/ k3 |: adisease features.
6 V; Z/ e; c: V

摘要：（STIM试验为法国的格列卫停药试验。）这个研究中，患者先是取得了CMR（融合基因转阴），然后停用格列卫，而后复发。15名复发患者在重新服药后又一次取得了CMR，他们同意再次停药。
/ v! W0 o* r* x( A$ X9 q0 T: ^3 U    第一次CMR持续时间为31个月，然后患者停药，复发的中位时间为2.6个月，然后重新服用格列卫，中位时间5.3个月之后取得第二次CMR。保持第二次CMR中位时间19个月之后，患者同意再次停药，这次，15名患者中有5名在停药随访中位时间24个月后仍然保持了CMR，而10名患者在停药中位时间2月后第二次复发。
    请注意，这些患者都是在第一次CMR后停药然后又复发的患者。

作者：来自法国STIM试验
来源：EHA 2011.6.会议摘要

很不错的文章，看来马老师家有考虑停药的想法了啊！祝福！

期盼易或特也能停药，但现在觉得是一个梦想！

这个非常有意义的研究。能吃下来停会再吃，再停，那是天大的好事