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。! f# R- M! Q; M
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。 J# B5 [3 ?8 v/ ~
* l* m' N. U& ^1 Z/ J/ L作者：来自澳大利亚+ H: ]* N+ y' n- w+ A+ g
来源：Haematologica. 2011.8.9.3 g3 B# d" y4 k8 r) h
Dear Group,' T# [3 x- B* e9 S
* }; B1 i7 a9 k5 Y% p4 F" C" _
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
" f* @ R1 V/ W8 atherapies. Here is a report from Australia on 3 patients who went off Sprycel! P7 \# W0 ~. U5 `. ]( A
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
1 `5 h. S0 k! S( }$ K, E) Y% uremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
9 m3 z, r% R: }! \* u( [does spike up the immune system so I hope more reports come out on this issue.* g% G( i, e/ v, `+ S. v4 V
( n) p; q0 T/ R2 x( q+ h6 q
The remarkable news about Sprycel cessation is that all 3 patients had failed
$ ^$ N8 e+ h0 M9 _. u C, YGleevec and Sprycel was their second TKI so they had resistant disease. This is8 Y0 [0 e* E/ H& o# d
different from the stopping Gleevec trial in France which only targets patients
/ y& G6 q$ l* k' S3 Q4 \# W: hwho have done well on Gleevec." D. n: y" Y& K& t# o) d/ z
) R1 m8 W: [2 M9 lHopefully, the doctors will report on a larger study and long-term to see if the
6 ^+ P2 D- d+ q( U. @# @$ kresponse off Sprycel is sustained.0 d4 }# }( T) b2 c& ~0 [5 q+ |
) r3 h& S- M3 Y( Z) p0 R+ z/ bBest Wishes,, w7 X$ l S9 h* o
Anjana
( y6 Q/ Y/ |8 l* l6 K0 @0 c' @$ { b3 V; M3 x
: e% K' f1 z* M" K$ Q: Z P$ b: \ f3 Z
Haematologica. 2011 Aug 9. [Epub ahead of print]" y R- B6 K6 n7 `0 u
Durable complete molecular remission of chronic myeloid leukemia following. D4 m) D& U+ f' Y
dasatinib cessation, despite adverse disease features.
2 v9 C% [' F4 l8 M4 D+ I! L4 B) I9 ^' yRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
1 X! u' \8 k& @5 aSource
4 M: N7 k& {4 |8 X3 r( n- bAdelaide, Australia;
! q4 ~, Z- z" [7 x3 k
9 G$ d. `. ]) A( R% ^Abstract# O( L6 ? i$ [& _( j2 a; T
Patients with chronic myeloid leukemia, treated with imatinib, who have a
6 T5 [" z/ e; z& x+ gdurable complete molecular response might remain in CMR after stopping* L. b$ S: J' Y* p9 Q# X
treatment. Previous reports of patients stopping treatment in complete molecular! d) Y/ @( N h2 P( W
response have included only patients with a good response to imatinib. We
* j! J: C. }) ~4 S7 T+ D% bdescribe three patients with stable complete molecular response on dasatinib
D; R, R; ?% o+ d4 N2 rtreatment following imatinib failure. Two of the three patients remain in
' o' | L8 v/ P) z; M) q: u6 Wcomplete molecular response more than 12 months after stopping dasatinib. In0 e/ t4 y! h; w; B- Z
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to( J6 H# L: o: R u% D6 a
show that the leukemic clone remains detectable, as we have previously shown in
1 W& [, k1 w/ V8 ^# himatinib-treated patients. Dasatinib-associated immunological phenomena, such as3 ^7 w4 D" H" p8 u' B+ N
the emergence of clonal T cell populations, were observed both in one patient. n; P7 h+ b! s6 L. w- F; E* f; n
who relapsed and in one patient in remission. Our results suggest that the
3 h2 e& s, Z2 Vcharacteristics of complete molecular response on dasatinib treatment may be
( l' N, o6 Y$ Msimilar to that achieved with imatinib, at least in patients with adverse
$ {9 F' r5 |5 v1 cdisease features., Y4 {5 m1 f0 y" }1 o5 R# Q
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