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。3 f7 n, S3 w, K* Z0 F
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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作者：来自澳大利亚4 F j; K$ `/ A1 w& R) z3 ?
来源：Haematologica. 2011.8.9.3 i- D f( b4 h/ s$ Y
Dear Group," v) o+ F4 g' ~7 O! T. }
+ d" p3 J3 Q$ \& ^) L# e# dSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML( P3 k" f% b3 t9 s' c3 ^
therapies. Here is a report from Australia on 3 patients who went off Sprycel
) R5 i1 F/ h( }- I$ x i% n- gafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
" k, X% J' f4 f0 \; L, Qremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
, I+ t& r. z5 j1 p3 D7 Fdoes spike up the immune system so I hope more reports come out on this issue.
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The remarkable news about Sprycel cessation is that all 3 patients had failed0 l% P2 X- l. y) [% C% `; z/ K
Gleevec and Sprycel was their second TKI so they had resistant disease. This is5 A5 d( G5 ^/ u) Y% J
different from the stopping Gleevec trial in France which only targets patients
- v* R7 ]7 h8 C8 A( n+ A0 iwho have done well on Gleevec.* ?9 U) s( I) k6 O
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Hopefully, the doctors will report on a larger study and long-term to see if the
( C' h3 A, \/ Hresponse off Sprycel is sustained.
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Best Wishes,2 l1 d8 Q4 ]/ l3 ~, Q) Q
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
7 a' n. A `6 L/ g4 MDurable complete molecular remission of chronic myeloid leukemia following# I5 X+ ^7 f+ t* V
dasatinib cessation, despite adverse disease features.
! c; D9 o3 z! ~; ORoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
c" p0 S8 r( d+ Z6 f, ~2 }3 hSource
8 |# Q3 C. P$ m9 T. u5 r' \+ eAdelaide, Australia;
8 `* u! x6 p4 @8 [4 r6 @, E/ T. ^9 A9 B. h' L; ~5 S1 A
Abstract! ~ Q) w( o0 `$ p p) ~
Patients with chronic myeloid leukemia, treated with imatinib, who have a
1 g. B5 D) I* e' Z6 q6 Fdurable complete molecular response might remain in CMR after stopping# N' i( L$ V4 Z6 u! t
treatment. Previous reports of patients stopping treatment in complete molecular
) A# S) |2 N% e8 J: R+ }& sresponse have included only patients with a good response to imatinib. We
8 y% ^8 R$ ?+ F; A; O& } y% _$ Y: T3 F* tdescribe three patients with stable complete molecular response on dasatinib
% [* ?1 d* W6 t1 W9 w" w+ b6 ]* o# Etreatment following imatinib failure. Two of the three patients remain in. Y# S1 R H9 h" M; s3 k5 u
complete molecular response more than 12 months after stopping dasatinib. In
6 p0 l- e, ~1 W1 u1 K* [) L9 B+ A1 Q2 bthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to' s7 g( q# W/ s4 C5 f5 u9 \! L5 q) g
show that the leukemic clone remains detectable, as we have previously shown in
8 ~( w6 l8 V! P9 @$ mimatinib-treated patients. Dasatinib-associated immunological phenomena, such as0 O' d( F2 H$ V7 A5 v& W
the emergence of clonal T cell populations, were observed both in one patient; T) v( M9 s M
who relapsed and in one patient in remission. Our results suggest that the, L: d8 ]" Q, O
characteristics of complete molecular response on dasatinib treatment may be
9 |8 @: k2 J9 T" I' H, z* h+ ssimilar to that achieved with imatinib, at least in patients with adverse
- \" l: [, i* T* Fdisease features.9 j# L# b5 f! f C
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