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。 ~5 w, ^2 r; \& H }* ]3 v+ ~! m* b6 G
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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* v( W9 w; _5 d作者:来自澳大利亚) S' i' X, d8 F3 g) b0 Y" Q
来源:Haematologica. 2011.8.9.5 W/ b! g7 f& A4 _
Dear Group,
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4 {) B6 g$ Y, xSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML& L, ?- Z$ G) M/ U) g
therapies. Here is a report from Australia on 3 patients who went off Sprycel
6 ]3 W( p0 _8 s/ |; cafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients& L" a: l! f7 m3 R
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel# x2 p8 h2 J0 R/ H) y' _ f
does spike up the immune system so I hope more reports come out on this issue.
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$ v# p! E5 a9 S8 H* iThe remarkable news about Sprycel cessation is that all 3 patients had failed& c& _0 y2 K! e- j% q
Gleevec and Sprycel was their second TKI so they had resistant disease. This is; [3 T! P9 {5 m/ g8 d2 D
different from the stopping Gleevec trial in France which only targets patients
( ?5 P& [, H+ awho have done well on Gleevec.5 w; n0 n I, T6 q
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Hopefully, the doctors will report on a larger study and long-term to see if the: y! k9 P* n7 L$ F0 c; U7 w2 D* p
response off Sprycel is sustained.
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1 X! N2 u5 \: ABest Wishes,
7 z: I& V- e& V' s/ ?8 p7 mAnjana5 a- Q5 |) ~5 Z1 g6 {
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% C7 k$ l; N% K: ], QHaematologica. 2011 Aug 9. [Epub ahead of print]/ O& R' w* o4 a2 s( P7 i/ I; l
Durable complete molecular remission of chronic myeloid leukemia following6 M( g6 x" n' X' R' j4 v3 C
dasatinib cessation, despite adverse disease features.. ^" }3 [3 w) g9 \
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
# o9 X. I" b. d& ? Y! u, KSource( m1 d% R) v2 ?( _% ]# V" @! R! v
Adelaide, Australia;) a/ z! ] d; ~6 i1 C3 h
+ _/ m# i* r1 ZAbstract2 E! M9 F# \0 a5 k- X% i
Patients with chronic myeloid leukemia, treated with imatinib, who have a
# O! F; I4 M1 y) B& Ddurable complete molecular response might remain in CMR after stopping9 I; a- d1 s+ g" Q0 N
treatment. Previous reports of patients stopping treatment in complete molecular( u u/ ~% C6 o/ G1 ?
response have included only patients with a good response to imatinib. We0 M! Q I! F) j7 R0 Y5 |4 s; T
describe three patients with stable complete molecular response on dasatinib
. s3 {; C* x. _& A5 Q5 _# i3 _treatment following imatinib failure. Two of the three patients remain in; x, L/ ]; l( n4 |/ K6 K
complete molecular response more than 12 months after stopping dasatinib. In
: o2 Y+ J& x$ T* u2 F$ r& athese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
5 a; h( v& g- }show that the leukemic clone remains detectable, as we have previously shown in
; M' Q0 n+ h. i1 W0 q+ \9 B9 y2 x, Vimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
7 ?* F5 \4 b& O: a- O8 _" U6 Rthe emergence of clonal T cell populations, were observed both in one patient! V7 Z" x! w: U5 q
who relapsed and in one patient in remission. Our results suggest that the
2 G1 k+ }6 a- X4 `3 s+ h1 rcharacteristics of complete molecular response on dasatinib treatment may be! Z' Z3 e! Z8 H% p. l" P. z. c5 x2 m
similar to that achieved with imatinib, at least in patients with adverse b, m# q9 _+ G! p' O! t$ i
disease features.
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