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。

. ?+ F$ T4 m3 }3 a; O作者：来自澳大利亚
6 ]' v" j$ \- V/ ^7 H来源：Haematologica. 2011.8.9.
Dear Group,
2 ~( t8 n& `5 L9 Q
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
9 I; s5 l& ^; stherapies. Here is a report from Australia on 3 patients who went off Sprycel
6 g3 F% R% v1 k5 x- K# d# c/ yafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
, u. O) @7 Y# D, r+ z# g3 l; [remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
does spike up the immune system so I hope more reports come out on this issue.
5 @5 H, N7 h; }
3 Y- l# ~  P& e3 R5 Z9 aThe remarkable news about Sprycel cessation is that all 3 patients had failed
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
5 J" G$ C$ E' W/ y9 m% ndifferent 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
# E( e* C' `9 p9 z2 a3 l. _response off Sprycel is sustained.
. q8 X4 X; g: T: _
Best Wishes,
6 N- a" [1 f& v3 AAnjana

. Q4 I, p% M/ L, c: |, W/ P
2 i/ c9 u/ l: Q( q( {
Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
5 s# m% q% B) P9 v. z& D- ?; X/ Ddasatinib cessation, despite adverse disease features.
) M% r- {4 A1 SRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
& k# o/ M1 F4 |$ d0 A0 J! SAdelaide, Australia;

0 [0 k: t4 W6 D" c. x4 SAbstract
9 |1 C6 v0 X5 D3 V: @7 u- x7 c" MPatients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
- F/ }  G' j3 ~, G& A$ [' n8 |treatment. Previous reports of patients stopping treatment in complete molecular
6 h4 u# s5 F/ |4 l7 Eresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
. q" X; U# G4 b, v0 Gtreatment following imatinib failure. Two of the three patients remain in
# K* s) n6 ]# K9 e) m: V) ncomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
show that the leukemic clone remains detectable, as we have previously shown in
5 d# L! S. W# ]! x& ~; Rimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
who relapsed and in one patient in remission. Our results suggest that the
3 J/ b6 E; W7 O; p2 |' h0 Echaracteristics of complete molecular response on dasatinib treatment may be
+ d2 p7 ~: B  t3 S9 isimilar to that achieved with imatinib, at least in patients with adverse
9 F% L, F4 h. v/ w* q' edisease 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。
6 B6 e" G. D# \4 {; y    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。
& J8 p2 v' ~+ ~3 P
# q  ]* ~% A2 e" c! H0 `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