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.
Dear Group,

6 r" S, ~7 N4 z: [Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
% j; p7 u+ A0 f7 e/ {therapies. 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 l( |- e4 V2 I  m  W0 Bremain 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
8 c0 ]5 \* `0 ^8 ~9 z, g7 GGleevec 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
: k& ~% v3 g7 E) L/ m/ G; ]who have done well on Gleevec.

Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
1 y5 K' \# V6 o5 m/ b
Best Wishes,
Anjana

8 a: Z  j8 `& R" ^

) e! K8 ^- A* c) d$ {5 BHaematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
% ~/ b/ Z7 n. L# [1 ^8 sdasatinib cessation, despite adverse disease features.
9 T, z7 [4 a3 @5 e. I& x( fRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
Adelaide, Australia;
. z7 l4 s& P& ^6 m  ~* c
' T' U- D6 F* ]& e$ `. k6 L- m  fAbstract
: T# `/ g* x4 V' @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
: A9 w: C( S; U& I; l; d' {response have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
! s7 ~5 H+ |$ o0 otreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
' N4 W6 V/ U% O2 L8 Qthese 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
( t+ e+ r- ?, [# ^; l' [imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
who relapsed and in one patient in remission. Our results suggest that the
! k) X: f- A9 J# rcharacteristics of complete molecular response on dasatinib treatment may be
. g9 G. U. R/ z. y& Rsimilar to that achieved with imatinib, at least in patients with adverse
( H- O  u: I# j- P: H7 Qdisease features.

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。
    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。
8 q; u* u" X/ U) w) q( I/ ^
. I& w5 l( R. O% q& A9 i% L$ h% C作者：来自法国STIM试验
' B: I  M3 B1 K' o/ O1 ?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