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。
9 w5 F+ Q% L0 ]  c+ x- ^7 {, V  M    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
$ I4 z7 O+ _8 l& |7 l4 s来源：Haematologica. 2011.8.9.
) a+ |' a2 O" m0 A9 GDear Group,

Some 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
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
7 a* m& `9 t( }: e1 [5 Sdoes spike up the immune system so I hope more reports come out on this issue.
% o+ s* F* e& n6 N4 O
The remarkable news about Sprycel cessation is that all 3 patients had failed
: Y) b$ E0 p5 ?! \. L7 |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
- V+ G  V% d0 T0 g2 iwho have done well on Gleevec.

% s4 @9 `6 ^2 J1 p8 J. EHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
# H7 _( k% |4 T. f  [  K& L
Best Wishes,
Anjana

1 k5 [% J- Z1 m: V) Z
! F# ?4 X5 y; l1 V
Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
  z/ A$ q! r/ M3 b5 Adasatinib cessation, despite adverse disease features.
/ z+ F7 p( D( c, C$ O; }" [Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
3 c# D, x9 \4 ~6 gSource
' ]) o$ l- s+ U- R5 HAdelaide, Australia;
2 P" N: F4 P+ x' g
" D' V: D4 v/ EAbstract
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
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
1 I7 g, p- M7 D+ b" K6 ?complete molecular response more than 12 months after stopping dasatinib. In
! x' V( \# Y# @" kthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
$ c) c, M" M. ]- s' T/ L2 b5 bshow that the leukemic clone remains detectable, as we have previously shown in
$ \. \2 E. C6 H2 @$ d& Rimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
* m; w3 v& p9 j$ Dwho relapsed and in one patient in remission. Our results suggest that the
4 O& G) c! }& W1 B* v2 r: u; Hcharacteristics of complete molecular response on dasatinib treatment may be
( W0 Y# }9 S1 L) V2 csimilar to that achieved with imatinib, at least in patients with adverse
* Y0 }9 ]% K2 x7 b5 Y: q2 R: Idisease features.
' D" h: t) U1 G: _* n) G7 J2 S! F" ^

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。
9 F: `6 X/ p* X* h    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。
0 l2 \  `6 B0 k: S$ L( c
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