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。
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作者：来自澳大利亚
: c: o0 ~# t7 k' y来源：Haematologica. 2011.8.9.
Dear Group,

Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. Here is a report from Australia on 3 patients who went off Sprycel
3 |9 o& Q& Q# l# c+ a" z: P' e( bafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
  r4 R) F7 ~( \; ^7 p4 P) p; }$ Rremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
! f% f8 m8 U  S  O# e# O6 kdoes spike up the immune system so I hope more reports come out on this issue.

4 z4 Y& J" Y0 I. g- y0 S7 _; wThe remarkable news about Sprycel cessation is that all 3 patients had failed
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
, M5 t/ e" ^& \0 z1 A% Odifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
/ t; f# I' J7 U8 ~1 L0 q
3 D/ Y2 w9 \) _$ m( B8 Z1 XHopefully, the doctors will report on a larger study and long-term to see if the
) ^1 V7 c* Y5 `' Aresponse off Sprycel is sustained.
  ~. R8 t! X0 i! `
8 F+ r5 i1 p2 h7 c+ FBest Wishes,
' x0 I2 K" R* V8 L' x  LAnjana
/ t* j/ @0 j7 @& O- ]; B
6 Q$ H9 h3 B: M

Haematologica. 2011 Aug 9. [Epub ahead of print]
# r7 @: D3 w" QDurable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
+ m& W$ ^: E4 Q) CRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
8 m. s: H) A: {- n. iAdelaide, Australia;
! U5 c, w+ M$ j- c- h2 p
3 ^. _: j8 N' {: V& rAbstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
; i7 j, E* Y, |$ H, v, Ndurable complete molecular response might remain in CMR after stopping
! T' [3 `; E- f6 ?& e: v/ H& Gtreatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
  j& y0 t6 _8 ]" j* b- edescribe three patients with stable complete molecular response on dasatinib
9 g) c7 O0 T8 T7 ptreatment following imatinib failure. Two of the three patients remain in
, x1 o8 R9 b) mcomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
+ M2 g, ?" E" P* x/ W7 Z1 Oshow that the leukemic clone remains detectable, as we have previously shown in
5 M3 k& J( c: v/ dimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
! W5 d/ i) {* z" o0 @) e; bthe emergence of clonal T cell populations, were observed both in one patient
% W7 C$ p2 ~9 g( J4 s2 y8 Uwho relapsed and in one patient in remission. Our results suggest that the
characteristics of complete molecular response on dasatinib treatment may be
# c% j' H: K3 m; o- Ksimilar to that achieved with imatinib, at least in patients with adverse
. v( m6 K1 R6 u- D) Pdisease features.
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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。
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作者：来自法国STIM试验
$ F+ j  \& E6 N2 y- K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