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。# V; [* Y, g7 c W- h
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
0 x% o: x( _2 Z来源：Haematologica. 2011.8.9.
9 z) E) d7 T+ p6 H. yDear Group,
8 z1 C6 r1 z3 Q% b4 i8 _* X4 ]1 j
- h! W8 U5 i& FSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
5 m- @; y0 J' W6 `) O% J: C" [4 ]therapies. Here is a report from Australia on 3 patients who went off Sprycel% t4 b h7 h# i3 J% H
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
" ^/ f$ t; t2 Eremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel7 L! b# c2 Y% ?7 q
does spike up the immune system so I hope more reports come out on this issue.
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The remarkable news about Sprycel cessation is that all 3 patients had failed
7 {( D8 s) [0 V% q2 c3 U! U( |Gleevec and Sprycel was their second TKI so they had resistant disease. This is
( L# K D5 Y* d/ Tdifferent from the stopping Gleevec trial in France which only targets patients
4 A7 J2 \3 Q6 r7 ywho have done well on Gleevec.
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5 i2 {+ b' n1 n: YHopefully, the doctors will report on a larger study and long-term to see if the
0 Y' S4 s+ }# \4 R% xresponse off Sprycel is sustained.3 ~9 \9 A; s' |( D G9 @. P. o
2 X: b* s/ u0 [& bBest Wishes, Z5 x* o7 e1 ^1 D
Anjana
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8 x m7 ^8 {$ H! D# R' {Haematologica. 2011 Aug 9. [Epub ahead of print]
, C( h8 a; @2 e8 }* u N/ J3 fDurable complete molecular remission of chronic myeloid leukemia following* i) C5 {5 x( Q& D" @8 Q
dasatinib cessation, despite adverse disease features.% S0 \: K' N+ g. M* k! C9 E
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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Adelaide, Australia;
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Patients with chronic myeloid leukemia, treated with imatinib, who have a7 _ c, h$ p. n3 J
durable complete molecular response might remain in CMR after stopping, G0 r: ~, O# J# `" R2 \! Q
treatment. Previous reports of patients stopping treatment in complete molecular
/ n$ \6 k- U8 d1 n% u0 a$ Oresponse have included only patients with a good response to imatinib. We" ~6 _# o8 b' z, h) g
describe three patients with stable complete molecular response on dasatinib0 V9 k) V: ?% W; L& R9 a
treatment following imatinib failure. Two of the three patients remain in/ P( P$ `4 B# }; t
complete molecular response more than 12 months after stopping dasatinib. In, B) D2 u. A2 [5 d+ o
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
% J3 y- A( D' y. y6 Q* H& Jshow that the leukemic clone remains detectable, as we have previously shown in3 j1 {8 W; \6 j2 `
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
/ [ O$ r6 x+ P2 q# Hthe emergence of clonal T cell populations, were observed both in one patient
- ~% J/ j" }4 x, @who relapsed and in one patient in remission. Our results suggest that the
( ?: ^& O# @7 lcharacteristics of complete molecular response on dasatinib treatment may be
% k& \) l3 H8 A& w6 h% _0 Gsimilar to that achieved with imatinib, at least in patients with adverse
+ w) B( [) B, a3 f6 n. O5 p+ Jdisease features.4 L0 D/ ~& ^' s4 l4 I% ^
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