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。
% W3 Y" y. b& Y8 Y1 h 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。4 I- z& u4 j; W
$ T# p% l* `7 F* \7 a6 U作者:来自澳大利亚* m; j( U3 F3 Y5 C: s% }) _
来源:Haematologica. 2011.8.9.
- P' y5 T! x$ z P, yDear Group,! Z/ Y: e3 m! n6 D/ i2 E( b
& {& f" G3 w' m& Z( ~9 H1 {1 _
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML9 H" `. y, M3 O
therapies. Here is a report from Australia on 3 patients who went off Sprycel4 G7 k" d3 f+ B7 j/ d, y- u, K" \
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients6 K2 Q7 V$ X- W) v
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel( ?; _3 S) U+ M& O. n
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+ s# Z/ F1 Q4 @: _! |4 T
Gleevec and Sprycel was their second TKI so they had resistant disease. This is6 T5 e* X" }% Q. f8 `1 |
different from the stopping Gleevec trial in France which only targets patients
d2 I6 [0 a$ E9 v: i' Z7 p+ p: ?who 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- Z$ S- F: K! C' n' f& V
response off Sprycel is sustained.
9 `: j5 v: d D2 G) u. x( D& {) |+ q( F6 L, R# g- ^
Best Wishes,
$ Q+ S. F3 b8 N+ w; YAnjana
7 g9 K% x! A9 [( n) {5 p7 {& f( U' s3 c i! |. A) b
9 F; x/ w+ |. r7 e7 X! h
- y2 e( u) |2 [! [" }9 u" pHaematologica. 2011 Aug 9. [Epub ahead of print]
2 y6 q V- S; n( [( S5 `1 @1 H- qDurable complete molecular remission of chronic myeloid leukemia following& P; j/ I2 Z1 i6 x: X& p
dasatinib cessation, despite adverse disease features.6 _) ?& p# Z0 Q6 c+ V
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
1 E0 l4 m; o+ G8 E; R+ ?Source) u, o8 ~! L- o
Adelaide, Australia;; L; H0 k3 \- }) R# K8 m
! D9 C, p8 R. u) _Abstract; a, K* a8 R; S5 g/ e* L
Patients with chronic myeloid leukemia, treated with imatinib, who have a
" b$ W6 W2 b7 w# Vdurable complete molecular response might remain in CMR after stopping
2 Y9 N1 H' m% u9 W; Z1 Q' u8 l; A/ Htreatment. Previous reports of patients stopping treatment in complete molecular& Q7 G3 f# G; R, P' v9 U
response have included only patients with a good response to imatinib. We4 D; Q; A3 m; L" r# i( C! M( j
describe three patients with stable complete molecular response on dasatinib
- S W: g+ r3 G/ \( Ttreatment following imatinib failure. Two of the three patients remain in
( P7 _7 L4 P- T: U1 Dcomplete molecular response more than 12 months after stopping dasatinib. In
3 i' q! e3 F. V+ Sthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to6 b9 F8 j4 o2 v! R9 d; k9 i% w
show that the leukemic clone remains detectable, as we have previously shown in
. {" A" n& I1 T% g8 r2 \imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
- ]7 Q0 y! V& x) W3 tthe emergence of clonal T cell populations, were observed both in one patient8 `, G' t T1 A! j
who relapsed and in one patient in remission. Our results suggest that the+ m! u* P" T I7 Q: T1 x/ B
characteristics of complete molecular response on dasatinib treatment may be. y9 E, l) u H
similar to that achieved with imatinib, at least in patients with adverse
# z" o; K. k/ t& y0 I1 V. r' idisease features.' r- u2 a7 j$ Y
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