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 L. b& @0 W# ^- F' Q
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。( p" w l5 }: |' q) a8 A
: b: J; C3 F, Q8 L9 t* B7 Q% D作者:来自澳大利亚0 C+ L0 F9 E7 N; K( e+ f/ W) ^
来源:Haematologica. 2011.8.9.
0 {2 _' E! v5 s: X0 DDear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML6 S7 ]( C+ b5 F. X) Y! v. M! r
therapies. Here is a report from Australia on 3 patients who went off Sprycel, L7 J7 l5 v) |9 x7 P) d8 p
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients1 F8 B6 n6 Y8 |) E" h# w' S
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
+ P8 s, z" t% o5 K& V- l/ sdoes spike up the immune system so I hope more reports come out on this issue.# Z" a; c$ I D( [
" I9 |3 \# k# _) P3 _The remarkable news about Sprycel cessation is that all 3 patients had failed8 ~" I# d/ ` |% X7 j* Y
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
/ M8 ]; Q. g( v$ a/ xdifferent from the stopping Gleevec trial in France which only targets patients7 L! u# i8 f0 x( O+ e# R
who have done well on Gleevec.2 Y1 S& q/ }+ o- `& G) ]2 g& ^
1 {; c) Z1 H9 Z ?. D" {, `. yHopefully, the doctors will report on a larger study and long-term to see if the- @8 m& X7 J2 A; h, d
response off Sprycel is sustained.6 F( y* C* m- C4 N
E: \0 T, N/ I1 Z5 T! c; @5 lBest Wishes,, G% F5 k' R' x
Anjana( x3 w: o4 n' V" ?3 b; v/ n! J
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Haematologica. 2011 Aug 9. [Epub ahead of print]* H% d0 g3 w7 V3 r. K
Durable complete molecular remission of chronic myeloid leukemia following
3 c- \% l& M8 r- r. z" Z8 f0 E$ C$ Xdasatinib cessation, despite adverse disease features.+ ~5 N+ N. t+ E* Y" I
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.% g' D( @" V0 d# g5 o
Source
2 [7 A- p6 I( ~' z" x4 C; lAdelaide, Australia; a7 s+ o; x( y/ X7 K* j
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Abstract
9 M$ O8 f! r/ n8 y/ lPatients with chronic myeloid leukemia, treated with imatinib, who have a/ A# f% P: Z$ ?; l) Q
durable complete molecular response might remain in CMR after stopping6 A, B' z; q! q
treatment. Previous reports of patients stopping treatment in complete molecular
. T- `, q0 X% z( [+ R6 C$ W; U3 K5 Sresponse have included only patients with a good response to imatinib. We
( ~& Y9 Y5 t1 a* Fdescribe three patients with stable complete molecular response on dasatinib
6 h# `, w& k: X; ^8 E9 atreatment following imatinib failure. Two of the three patients remain in# J! g/ c( g% y' H* E* B0 G
complete molecular response more than 12 months after stopping dasatinib. In
{0 ~/ E% R% M' @: a8 p3 ethese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to, A- N: F# R) q2 D, |+ H. }
show that the leukemic clone remains detectable, as we have previously shown in
$ b: F: P E9 i* simatinib-treated patients. Dasatinib-associated immunological phenomena, such as
% p& t+ s" H. v5 n+ m+ _the emergence of clonal T cell populations, were observed both in one patient" f$ P" t- M8 I
who relapsed and in one patient in remission. Our results suggest that the0 |0 i) P# J8 g( x6 a4 X: ~
characteristics of complete molecular response on dasatinib treatment may be: I3 L# n0 m! A7 O" S
similar to that achieved with imatinib, at least in patients with adverse) _# v% U- Q: C- l: C
disease features.
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