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。
* a4 v6 q2 f K& `8 o! J9 N0 ~$ x 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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9 q1 p8 K, y1 Q' G8 y0 k0 o+ C+ i作者:来自澳大利亚; E @' r) U' ~, g* ?& Y7 t
来源:Haematologica. 2011.8.9.6 [' I8 v+ A+ |7 @
Dear Group,2 @! L/ ~: s, \, N7 ]8 m
! n5 L7 I% p; _9 {+ r$ I9 P) ]Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
7 o% n4 }/ H8 p! ?therapies. Here is a report from Australia on 3 patients who went off Sprycel3 B2 X9 z2 I# e/ k$ _: c
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients% F3 {( m2 h. ?" g( R2 C; E
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
; M! h. |( y) p! s0 P8 l' Bdoes spike up the immune system so I hope more reports come out on this issue./ {" E* K4 ]6 {, S
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The remarkable news about Sprycel cessation is that all 3 patients had failed8 e* Y# p2 {7 h
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
8 s& c# j/ d; M3 R1 Y" bdifferent from the stopping Gleevec trial in France which only targets patients
: ?5 \+ I- D0 ]0 C, E5 iwho 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
* ^5 ]2 ~' q: Q: k) u6 q- C/ o' Y* }response off Sprycel is sustained.' j/ }& i J" G* k7 l
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Best Wishes,
) P3 H6 K4 C9 M; K. u" \- t& iAnjana
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( W h: ?7 k/ J: }Haematologica. 2011 Aug 9. [Epub ahead of print]! J! q+ }# g3 X. o7 j( f
Durable complete molecular remission of chronic myeloid leukemia following
* o1 r7 a6 j) D7 Cdasatinib cessation, despite adverse disease features.
' a& y8 k# [& c2 d- _Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
. ^ W' |$ r& _$ g( fSource
7 m/ f% Q; K7 Y2 l' a; ZAdelaide, Australia;$ j+ Z) M/ u7 G+ I2 G; y$ s
7 ^: o4 `5 t U2 W) I4 ]+ w4 {Abstract
; g8 r" P h* O- yPatients with chronic myeloid leukemia, treated with imatinib, who have a
, C7 c0 I' z" G; i2 `durable complete molecular response might remain in CMR after stopping
# d& O3 b6 t9 q# Y3 jtreatment. Previous reports of patients stopping treatment in complete molecular" n m: C3 i' ~: m
response have included only patients with a good response to imatinib. We& Z; I6 D. y7 K9 u
describe three patients with stable complete molecular response on dasatinib/ n; v5 w x. R
treatment following imatinib failure. Two of the three patients remain in' {! h! w4 Y7 J% X8 w0 F( X* g3 t
complete molecular response more than 12 months after stopping dasatinib. In( f$ a' i4 Q+ @% _- u0 f* Z. x
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to# K6 w4 \( c: w
show that the leukemic clone remains detectable, as we have previously shown in! ]; ~4 h- q0 k% D$ O' C, `) P# `
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
/ y( ?3 \5 k6 W1 Q) lthe emergence of clonal T cell populations, were observed both in one patient
6 T- I% l& f1 J. I! iwho relapsed and in one patient in remission. Our results suggest that the
. ?( }) v& W* M6 k/ R( ]. kcharacteristics of complete molecular response on dasatinib treatment may be
: h; W0 \( O/ lsimilar to that achieved with imatinib, at least in patients with adverse& e; w- d* r. `4 S
disease features.1 w9 j9 a& K2 v1 y. g& Q
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