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。! j1 m0 B5 x Y' I9 K, l
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。; [( F9 _, A% C* v5 j2 ^! W
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作者:来自澳大利亚* U4 m9 P7 n/ U2 l+ s* c
来源:Haematologica. 2011.8.9. ?$ Z, c' h0 u# p- W7 I
Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
; r% [- V: }) x0 K$ w3 ~9 Mtherapies. Here is a report from Australia on 3 patients who went off Sprycel
" V6 S* Q, r" ~9 i! \5 l, Qafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients; Y9 u% E4 H! Q) k/ g$ N' e% \
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel0 X" q) f1 W- M. R) c
does spike up the immune system so I hope more reports come out on this issue.
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# F$ u$ F( A4 f. L) FThe remarkable news about Sprycel cessation is that all 3 patients had failed, m( S( ^# S% J( N* n
Gleevec and Sprycel was their second TKI so they had resistant disease. This is% U* `$ W3 }9 s% V
different from the stopping Gleevec trial in France which only targets patients
* T6 i# B! T- m# j+ D3 Jwho have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the6 `9 E& ], A* Y8 \! q2 ^7 u
response off Sprycel is sustained./ D n4 N) d8 ?! h# [3 c
( y! u& K- r9 U* ZBest Wishes,! M) D# r: d! O9 X, F
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]+ J# L6 \3 }6 a6 k. \7 x! G
Durable complete molecular remission of chronic myeloid leukemia following6 Q1 Y4 } z' Y9 n2 c) }% a8 p
dasatinib cessation, despite adverse disease features.
4 g: R X2 e+ H) L4 \. SRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
; V% _( N( `% ^: b0 ySource
2 ^$ P; ~4 D' VAdelaide, Australia;
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Abstract: t/ Q5 [2 U7 K+ `( x
Patients with chronic myeloid leukemia, treated with imatinib, who have a7 M3 q9 ~0 N D0 B G+ I9 R1 g+ D
durable complete molecular response might remain in CMR after stopping3 N$ N3 C- J8 s; @7 T- ?$ }5 x3 ?
treatment. Previous reports of patients stopping treatment in complete molecular' D! S1 d! c% l6 w( A' T
response have included only patients with a good response to imatinib. We
! F$ U. c# K$ e7 ydescribe three patients with stable complete molecular response on dasatinib% a! f5 n1 O& A3 h
treatment following imatinib failure. Two of the three patients remain in
6 D/ ^4 H: N% s4 i B& m) M! }complete molecular response more than 12 months after stopping dasatinib. In
$ G9 j/ L& O0 c. rthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to( Y2 A' {6 J* K- L3 |
show that the leukemic clone remains detectable, as we have previously shown in/ i D. l! U# F3 ~- r+ U6 d
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as7 S) A& {+ h2 K) j1 l& c. V$ }5 [) g
the emergence of clonal T cell populations, were observed both in one patient) ]! H: t2 [, V* ?1 R
who relapsed and in one patient in remission. Our results suggest that the) F- m5 \ {) c% ?3 N
characteristics of complete molecular response on dasatinib treatment may be& f( {# A8 ~. H9 V3 P' ~
similar to that achieved with imatinib, at least in patients with adverse# O4 |8 R" g8 p0 U) w1 N3 J
disease features.8 n2 D* u+ Z: B7 u! F' A
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