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。
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7 j' v8 K  F' |2 s, A作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,
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; S9 K) I& W% i: iSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. Here is a report from Australia on 3 patients who went off Sprycel
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
2 m7 I# s# H* d2 E( y' {remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
2 O, z2 W  q6 Z3 F; Kdoes spike up the immune system so I hope more reports come out on this issue.
0 q" _6 z1 h& e
) \4 F- m4 z# U; |8 vThe remarkable news about Sprycel cessation is that all 3 patients had failed
4 L  M% W& h" N/ y, S& \4 KGleevec and Sprycel was their second TKI so they had resistant disease. This is
! Y  {  }) d  F. E- H1 @( _different from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.

Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

! u" C$ a4 A" Y( I8 VBest Wishes,
' J' u" p' t( {2 `/ WAnjana
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& \7 p7 B: \) P6 r% n' K
Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
+ K  N3 Q: ^* ^9 r$ GSource
0 s& N# q* j& Q% y" |% ~Adelaide, Australia;
2 k7 }' E( ^2 `/ R; V. e. ]0 o
Abstract
* B( I: i1 p* y# mPatients with chronic myeloid leukemia, treated with imatinib, who have a
$ H0 ^: U: X$ Udurable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
$ y0 c+ W  o: }2 Acomplete molecular response more than 12 months after stopping dasatinib. In
% Y6 [8 ]) A0 m; Xthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
% B- a* z5 R) S+ |) Pshow that the leukemic clone remains detectable, as we have previously shown in
* i: \, T- f: i) E6 Z& u9 |4 vimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
3 r3 ?  f, V* v3 ^! u6 a2 qthe emergence of clonal T cell populations, were observed both in one patient
; N4 j4 B& |) d8 Mwho relapsed and in one patient in remission. Our results suggest that the
characteristics of complete molecular response on dasatinib treatment may be
2 }5 [& e# [" H  s/ Q# Bsimilar to that achieved with imatinib, at least in patients with adverse
0 m9 w3 U0 M4 ~5 c  Rdisease features.

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。
    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。
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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