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。
$ h3 y% L5 Y2 j- m2 s% }2 G% N% j 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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作者:来自澳大利亚
& I) b! v3 G0 E F来源:Haematologica. 2011.8.9.
; ^2 S3 t5 J. ?; }Dear Group,
S1 H$ n j2 U
5 h. N, A2 N! @/ S3 NSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML0 e) ^$ w5 q- n' {- P
therapies. Here is a report from Australia on 3 patients who went off Sprycel
" @2 }+ F9 O, b* \* _3 @; m4 J% uafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients! e& v4 b- L% j% w$ D4 Q* g1 z
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel2 J' ^" Y5 \0 j* R
does 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
+ E3 e& z7 g$ l0 |Gleevec and Sprycel was their second TKI so they had resistant disease. This is, k, Z. x( y+ j& q
different from the stopping Gleevec trial in France which only targets patients
) V5 X& K2 b; I1 x E2 V7 w. ?+ Awho have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the
3 B1 Q) U0 q; A6 aresponse off Sprycel is sustained.
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Best Wishes,
5 ~8 t% ]- ?- s* o: u" s9 `4 q& }Anjana2 H2 ~1 D# T1 A7 s
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Haematologica. 2011 Aug 9. [Epub ahead of print]
+ @9 }: M2 @7 s2 I7 YDurable complete molecular remission of chronic myeloid leukemia following
8 o P" c$ w4 f% v( h: ?dasatinib cessation, despite adverse disease features.+ C9 T/ R3 T3 W# u+ f% A& H
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.1 _5 n |2 A4 P6 f8 P9 y8 F2 U3 A
Source' L& a" _8 B0 C8 {
Adelaide, Australia;9 \1 q2 e/ l: G* o9 @
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Abstract
, \- G8 l6 w+ `" M. B0 ^3 H, fPatients with chronic myeloid leukemia, treated with imatinib, who have a
2 N: c. M: m2 P. p& n% j8 ddurable complete molecular response might remain in CMR after stopping
3 e+ F3 B( l& S; b) L4 |treatment. Previous reports of patients stopping treatment in complete molecular1 z+ B6 t8 I" R: {* a; _9 y
response have included only patients with a good response to imatinib. We
+ O6 L9 d+ y) fdescribe three patients with stable complete molecular response on dasatinib
" A& y R( X* y0 V$ b6 V3 gtreatment following imatinib failure. Two of the three patients remain in3 _9 m; K' k2 F: y2 v9 M
complete molecular response more than 12 months after stopping dasatinib. In1 Y) Z" Q/ _1 b& U0 s9 F* d+ b p/ C
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
. y/ e9 {. y& t$ j4 j8 h3 d% z: M/ Bshow that the leukemic clone remains detectable, as we have previously shown in0 H: C# V9 N7 @* W4 D/ g
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
1 r! L+ x% W6 V; d+ [( Ythe emergence of clonal T cell populations, were observed both in one patient$ { {* l( e, p7 m; C
who relapsed and in one patient in remission. Our results suggest that the1 y4 q# m' t5 V+ I. u6 {
characteristics of complete molecular response on dasatinib treatment may be
. ? L9 T3 k; N3 Q, Ksimilar to that achieved with imatinib, at least in patients with adverse
. J4 F; v2 S3 m* E) Odisease features.
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