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。

. h6 s; n4 J) h3 }# G* ^: k: S5 d7 p作者：来自澳大利亚
- E9 W5 P; l+ J5 k2 z" c  a  g2 n4 B来源：Haematologica. 2011.8.9.
Dear Group,
, r5 m1 D3 U$ K  b& h
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
( F0 x: i3 \. Ttherapies. 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
remain 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.
/ z1 {% {6 S7 \, P  E1 d
7 l, @$ o& D0 i& F! }The 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
different from the stopping Gleevec trial in France which only targets patients
" M7 `' Y+ v3 t0 j; ]who have done well on Gleevec.
% h. x! s0 [% s) v- a& P: h
Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

Best Wishes,
" f* J" d& l2 @. U7 a1 M5 N5 ~8 qAnjana



Haematologica. 2011 Aug 9. [Epub ahead of print]
8 E+ S1 y. o3 _$ YDurable complete molecular remission of chronic myeloid leukemia following
8 F' e) X; H' J: c# Jdasatinib cessation, despite adverse disease features.
$ U& _9 v6 I  r% L- ^7 Y5 vRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
4 G. P* ^1 e5 VAdelaide, Australia;

3 J+ G# g; J) m1 t: I$ ~0 _, FAbstract
2 d2 g) a2 ]. z  NPatients with chronic myeloid leukemia, treated with imatinib, who have a
$ h7 z* j1 i6 \( k# q' cdurable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
5 V" f, d3 t' s8 A, Oresponse have included only patients with a good response to imatinib. We
! D8 B8 F3 P3 i7 Ldescribe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
8 x/ E) S( p+ h8 D) K1 N, v1 Uthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
6 d$ |  J3 w- O0 |6 ashow that the leukemic clone remains detectable, as we have previously shown in
* C% h8 S# i1 q8 O- ximatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
9 N) S* U! Z0 e7 F) t  D) ^$ bwho relapsed and in one patient in remission. Our results suggest that the
0 b8 D9 G5 {! H  ?# {characteristics of complete molecular response on dasatinib treatment may be
$ C/ P$ f5 Y" h) S+ q! _+ R# fsimilar to that achieved with imatinib, at least in patients with adverse
disease features.
; T- T6 M+ `* Y7 m

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。
9 N- P3 i+ b; E, E9 c  I+ s# k    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。
4 [! C1 I7 b2 a/ f8 O! R8 U. Z7 G
; m9 }4 A/ d3 {) h作者：来自法国STIM试验
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