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。- |. x, D$ v8 |2 O% W2 m! s% S2 f
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。) U5 O. n; j' d( C
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作者：来自澳大利亚
" `$ R9 W# D+ |0 B% l来源：Haematologica. 2011.8.9.! A0 V4 \5 Q2 B. M0 h0 Z
Dear Group,0 O/ r7 D: D0 s
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML2 B d) L* x$ l1 I* Q1 l4 n
therapies. Here is a report from Australia on 3 patients who went off Sprycel4 {1 v6 \6 G, |# e0 Y9 Q
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
& R% Y3 A1 b5 q5 kremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
3 l6 L. y* t8 d, adoes spike up the immune system so I hope more reports come out on this issue.1 d+ E: v, V4 k2 d2 U$ a6 o
6 q. ~% p7 E% [; z* w3 z3 B6 AThe remarkable news about Sprycel cessation is that all 3 patients had failed8 s. b3 z. P8 C. h, y8 \
Gleevec and Sprycel was their second TKI so they had resistant disease. This is% ]8 |5 q9 G, @$ k! r2 Q- d. q
different from the stopping Gleevec trial in France which only targets patients, v$ }8 p: \6 Z0 }
who have done well on Gleevec.
8 W- N% z! \6 e6 O
4 {. m3 s8 c% l- j$ z: d' xHopefully, the doctors will report on a larger study and long-term to see if the; J8 ~8 \) |, D$ ]
response off Sprycel is sustained.9 a/ W5 `% u8 @1 u
6 @4 ]8 F$ o' T6 b0 UBest Wishes,9 `- i5 G0 p7 |1 ^ h" y
Anjana
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: X3 M) U' ^6 b1 S. a, D8 s
; w( F# A' ^ N/ r* EHaematologica. 2011 Aug 9. [Epub ahead of print]
) W! d5 r! p! C% q J3 h& WDurable complete molecular remission of chronic myeloid leukemia following
: ?. P; m3 T( Odasatinib cessation, despite adverse disease features.! A6 X' Z5 |! J# {6 H8 F3 ?
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
; ?8 v% x5 N3 z: I% _; H" P! SSource
1 d% u# o* l0 L6 w9 I" @. rAdelaide, Australia;& v: o2 e* V0 L% t+ H; {
: N( S4 Q8 H% Y- w: Y+ `Abstract& n3 M* }% s. B$ V( z
Patients with chronic myeloid leukemia, treated with imatinib, who have a
4 F( k" S2 C6 Y6 }& ]$ o& V# vdurable complete molecular response might remain in CMR after stopping
3 A+ k' N4 ^' p. k7 g1 N. Itreatment. Previous reports of patients stopping treatment in complete molecular
% I; \) @2 i- n( n, S# qresponse have included only patients with a good response to imatinib. We
+ d' w. H% B5 G0 X7 E# o+ Zdescribe three patients with stable complete molecular response on dasatinib
X* d4 O* Q3 B" g; o. O' D3 Btreatment following imatinib failure. Two of the three patients remain in
3 f3 V# _$ R- Z5 Xcomplete molecular response more than 12 months after stopping dasatinib. In
2 J% A0 c; N4 c, Pthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
( E7 ~# X. s$ b9 u) N/ Qshow that the leukemic clone remains detectable, as we have previously shown in
3 j$ [0 o; ^( i7 y7 _: q! }imatinib-treated patients. Dasatinib-associated immunological phenomena, such as- o2 g* k% o" h# y* H' ]( a1 u
the emergence of clonal T cell populations, were observed both in one patient! f. ]6 `4 j) o; B) N* S
who relapsed and in one patient in remission. Our results suggest that the% X8 j# k1 Y( e S( e
characteristics of complete molecular response on dasatinib treatment may be
- D% v( K& Z. j/ E2 @6 A. {similar to that achieved with imatinib, at least in patients with adverse
1 I2 ^# C+ r- Z! l5 j( c( i6 kdisease features.1 x1 g; j' b- V1 L+ ^( i
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