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。

作者：来自澳大利亚
& s$ B1 t* E4 \$ ]  b2 a$ {4 i来源：Haematologica. 2011.8.9.
) C+ D; g( T6 u$ b1 X7 a6 [Dear Group,

Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
) A$ g4 _  g) N# n* ntherapies. 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
3 Q% i0 v$ I  idoes spike up the immune system so I hope more reports come out on this issue.

The remarkable news about Sprycel cessation is that all 3 patients had failed
& O4 \& c" x% K& h6 LGleevec and Sprycel was their second TKI so they had resistant disease. This is
! W. D+ ^+ P/ r  {/ M2 A& V# h- }different from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
/ ^: w4 g" I& |6 U& q/ E
Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

2 Z* \. k) m4 TBest Wishes,
Anjana
0 W& ^; P# ?& ]- [+ z3 a. y
: u; S5 g' q' [2 T* A

5 h& W, l! v2 c3 o' O# Y0 MHaematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
9 \4 W- \* K+ t. x0 ldasatinib cessation, despite adverse disease features.
5 [% x" Z" b, {" z4 b3 y2 JRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
Adelaide, Australia;

$ i" ~9 g: a  Z: o# nAbstract
- |' k1 n6 i4 h; L  @: g2 WPatients with chronic myeloid leukemia, treated with imatinib, who have a
* V% e% }4 U+ I; R2 O) i* Ndurable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
) i4 p/ a. [* ^7 R; H) C" j6 D5 Eresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
4 M; z% ~" o4 T4 G: ktreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
5 w2 G! |. C) E8 H0 c, K6 ?! Qthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
( e. v- b3 H- [% H4 ^8 {show that the leukemic clone remains detectable, as we have previously shown in
4 X( e4 ]" @; Z+ Qimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
3 v+ E2 J5 V- M( u( athe emergence of clonal T cell populations, were observed both in one patient
5 a0 i/ d3 @% A7 X+ T' Zwho relapsed and in one patient in remission. Our results suggest that the
6 B& M# W% J6 r. G% Hcharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
( n" w! v$ G4 d" C- m' r/ Ndisease features.
2 w3 n$ R& k% v5 j: I

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。
8 T6 F5 P; n; Q+ h    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。
8 W7 \6 [" a! p
8 k# w' H6 k$ E$ u0 u- `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