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 `8 s$ }9 C: K8 R. |9 C
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。$ _6 ]7 l) F3 I# P( t+ J) Q
. X0 x8 E' |# Z& T作者:来自澳大利亚
1 S' z8 c3 v) d7 L来源:Haematologica. 2011.8.9.( O; m: A7 `# @$ W) D; V4 T. L
Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML6 K* K9 |7 ]0 b9 B4 H c
therapies. Here is a report from Australia on 3 patients who went off Sprycel* M! J' z& ~; o- W
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients' T4 k$ |1 S% X% ?* N( s- {7 S
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
1 b& p/ r- _: M8 Pdoes spike up the immune system so I hope more reports come out on this issue.9 a9 z" g0 Q: M8 n5 W
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The remarkable news about Sprycel cessation is that all 3 patients had failed2 ]) s2 j$ ~% y# O6 [; u g; B$ |
Gleevec and Sprycel was their second TKI so they had resistant disease. This is" |4 _6 @ s- `7 F% M
different from the stopping Gleevec trial in France which only targets patients+ q" i- T6 g: @ x& @3 I6 Y
who have done well on Gleevec.# b* W. w B) M. V* o7 L" U9 L, I
2 E4 s! c% Y! @$ D5 e3 z0 I5 [# C3 tHopefully, the doctors will report on a larger study and long-term to see if the
4 l; T# v. k0 M8 Xresponse off Sprycel is sustained." E: L1 j' P7 f! i
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Best Wishes,
9 O& L7 F& |; T6 h2 M9 ^) i8 I, EAnjana- r: }! W g" _2 {+ r' a4 S, E
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Haematologica. 2011 Aug 9. [Epub ahead of print]# Q: j& `( R5 x% W# W. L
Durable complete molecular remission of chronic myeloid leukemia following
& s p! ?, U$ x8 S. p6 f, F) idasatinib cessation, despite adverse disease features.. J4 B5 W& o" [3 g: ]
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.$ g* b0 h4 [5 @
Source3 z& r. m% N1 |
Adelaide, Australia;
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Abstract8 g8 {' S& @3 T6 H/ @7 ]
Patients with chronic myeloid leukemia, treated with imatinib, who have a
8 J2 w6 N. I1 N& G- z8 sdurable complete molecular response might remain in CMR after stopping
& i& _- {7 `% r8 ~# J1 F' L( Ptreatment. Previous reports of patients stopping treatment in complete molecular
2 a) ^" Q+ B* G4 m# s% {& c- `response have included only patients with a good response to imatinib. We& w+ R6 |0 F$ h0 z! I7 e
describe three patients with stable complete molecular response on dasatinib
- C1 L% I+ A; A1 o& l* A4 w/ p* Gtreatment following imatinib failure. Two of the three patients remain in( }1 @9 q9 P: p3 U7 V+ |( W- e$ A$ I$ Q
complete molecular response more than 12 months after stopping dasatinib. In
8 Z1 [; m( U0 a5 Athese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
" c9 d) L k) n; `6 _show that the leukemic clone remains detectable, as we have previously shown in* v# I' t4 z& Y5 N4 v0 L' X
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
3 o4 M. y4 D) y- G! v4 K4 }the emergence of clonal T cell populations, were observed both in one patient
' H% H" | m y/ Gwho relapsed and in one patient in remission. Our results suggest that the' r" T6 Q* k7 q1 i% `; `5 C/ D
characteristics of complete molecular response on dasatinib treatment may be
) P! e E' s7 X3 x" \similar to that achieved with imatinib, at least in patients with adverse
2 a6 r' J u J y1 Q9 ndisease features.6 e) M; O7 j5 m. n2 F. n4 W9 S
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