关于停药的相关内容

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。
    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。

作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
2 g2 m8 o  g0 m; k2 X0 dDear Group,

$ b* l" h' Z* W. o! oSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
* V3 H9 C1 w% W% _0 ]' ltherapies. Here is a report from Australia on 3 patients who went off Sprycel
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
1 W1 ?& S% x5 kremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
does spike up the immune system so I hope more reports come out on this issue.

The remarkable news about Sprycel cessation is that all 3 patients had failed
3 U4 e& |% a) g3 C; f( DGleevec and Sprycel was their second TKI so they had resistant disease. This is
different from the stopping Gleevec trial in France which only targets patients
- R1 ^, \0 C, T" J. F# ?. H2 owho have done well on Gleevec.
- n4 [" H7 m, o
Hopefully, the doctors will report on a larger study and long-term to see if the
; d' D# `: X- ~response off Sprycel is sustained.

Best Wishes,
Anjana
& ^$ z7 y& A0 D' L


- l* G1 m+ C; t/ ^Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
% `0 Y8 v, S' h2 S9 PRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
  C$ f% }; U0 C: ]0 h1 lAdelaide, Australia;
: C+ {6 @' P7 _! e; J: ?; ~
Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
& }; H, u2 ]5 V7 B8 t: f) A; d+ tresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
5 c7 \0 ^* [4 c- F" lcomplete molecular response more than 12 months after stopping dasatinib. In
5 x/ D4 w. [: Z6 `these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
show that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
1 w5 O# \; q) i4 _: a+ \4 Fthe emergence of clonal T cell populations, were observed both in one patient
6 s3 e" W8 l- [. s5 mwho relapsed and in one patient in remission. Our results suggest that the
$ i+ F' s( a6 p1 Fcharacteristics of complete molecular response on dasatinib treatment may be
  N; i$ K, I5 Bsimilar to that achieved with imatinib, at least in patients with adverse
disease features.
8 l' p# I) o+ t

摘要：（STIM试验为法国的格列卫停药试验。）这个研究中，患者先是取得了CMR（融合基因转阴），然后停用格列卫，而后复发。15名复发患者在重新服药后又一次取得了CMR，他们同意再次停药。
    第一次CMR持续时间为31个月，然后患者停药，复发的中位时间为2.6个月，然后重新服用格列卫，中位时间5.3个月之后取得第二次CMR。保持第二次CMR中位时间19个月之后，患者同意再次停药，这次，15名患者中有5名在停药随访中位时间24个月后仍然保持了CMR，而10名患者在停药中位时间2月后第二次复发。
9 C6 h  J9 h7 T7 e; \    请注意，这些患者都是在第一次CMR后停药然后又复发的患者。
  }) ~" X7 J: `1 `/ I
7 |% R- |- M  |1 [/ A作者：来自法国STIM试验
来源：EHA 2011.6.会议摘要

很不错的文章，看来马老师家有考虑停药的想法了啊！祝福！

期盼易或特也能停药，但现在觉得是一个梦想！

这个非常有意义的研究。能吃下来停会再吃，再停，那是天大的好事