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。
4 i! m; @7 L% Q" k [$ ~ 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
( T# d! K4 J* t2 B+ @* ~" T! \来源:Haematologica. 2011.8.9.
/ n) A, d4 o6 T8 G+ \' R+ BDear Group,# B5 s, W: D$ ?5 P( u7 r
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML# T- i! A& V* @2 a$ u1 e/ [
therapies. Here is a report from Australia on 3 patients who went off Sprycel0 {. [( n! J- w' F3 h7 u
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients: O1 z, @2 B. Y1 p/ q; F ^
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
$ ~3 P1 {8 k0 Wdoes spike up the immune system so I hope more reports come out on this issue.% N' [5 M8 S# Q5 {" }8 J
4 F- q; S8 a! U N; |4 PThe remarkable news about Sprycel cessation is that all 3 patients had failed
0 p0 y0 f! N1 i0 |9 F; ?, z4 cGleevec and Sprycel was their second TKI so they had resistant disease. This is1 s' X( P- s3 Q
different from the stopping Gleevec trial in France which only targets patients2 r7 ~3 z+ l6 \" ?! U
who have done well on Gleevec.% J8 T( B+ B8 i1 \; f( D
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Hopefully, the doctors will report on a larger study and long-term to see if the4 i% }; Y4 @/ K! \+ Y5 n
response off Sprycel is sustained.) a; H. N( W! I( g# [
! u# r- u4 a9 e7 m# T+ EBest Wishes,4 A8 b0 z) s! f' G# S9 q6 R
Anjana
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3 E- u, [% C1 L) X- P7 G2 N$ MHaematologica. 2011 Aug 9. [Epub ahead of print]
/ g6 } _% s- X- _; o: _/ F! pDurable complete molecular remission of chronic myeloid leukemia following. ?5 ], v- k2 f
dasatinib cessation, despite adverse disease features.
( c: T3 C" y, c4 O6 A+ vRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
) B% \0 j1 L, @6 d7 t, Q6 E' S3 bSource) y- _1 ~6 a9 b! w: j
Adelaide, Australia;& n! _4 g6 i+ e) U% Y
# r4 q3 m3 p0 fAbstract: J3 A/ _1 \& k; Z- s9 k
Patients with chronic myeloid leukemia, treated with imatinib, who have a4 x5 \" B& j6 F9 S
durable complete molecular response might remain in CMR after stopping
1 k; H) o; f ?) W$ [treatment. Previous reports of patients stopping treatment in complete molecular7 X7 I y2 Y2 T* ]& o7 J, _" G. L
response have included only patients with a good response to imatinib. We8 d6 X2 \+ U1 @$ z3 j. M; S5 {1 n8 A
describe three patients with stable complete molecular response on dasatinib, p2 o: U: s) J1 G
treatment following imatinib failure. Two of the three patients remain in
5 Q) d3 i F# a, ?& {% ccomplete molecular response more than 12 months after stopping dasatinib. In( L$ I" X" R/ _, b9 L+ a
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
; t& F4 ^: k) f' b: H9 Q$ |show that the leukemic clone remains detectable, as we have previously shown in
$ w8 p8 B6 F5 ?: `+ ?imatinib-treated patients. Dasatinib-associated immunological phenomena, such as# p5 ~$ D F# z8 D6 n. ?
the emergence of clonal T cell populations, were observed both in one patient
& Y% q/ `* |9 i3 gwho relapsed and in one patient in remission. Our results suggest that the. Z W8 |. O/ Y/ L, }
characteristics of complete molecular response on dasatinib treatment may be
: P6 N5 Y; p# W) F2 @& m% o7 ?, s3 O& Vsimilar to that achieved with imatinib, at least in patients with adverse
$ @6 H1 ~0 l) Vdisease features.
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