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。. b+ i, m% A0 x/ H* v
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。9 w& L: k! S: T& i
# \2 V+ }1 C4 R作者:来自澳大利亚3 G7 c b% p1 r9 p9 C7 V+ R+ d
来源:Haematologica. 2011.8.9.
" o4 T1 U* {8 G4 c. qDear Group,
; j3 a% X0 G6 p% k5 g9 @* X7 g. u9 [2 y5 b3 s$ H6 l. t3 S
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML" K2 V. Q4 Q. a
therapies. Here is a report from Australia on 3 patients who went off Sprycel
5 v w! M# p) R1 Y" Uafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients |5 N( A, R1 q. @, f, d3 p
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
+ V. L0 J; x. \0 ]: W9 l) O, Edoes spike up the immune system so I hope more reports come out on this issue.
2 `+ F1 w! b. f2 n: u
2 f( k' r3 [4 {- G. i Q/ QThe remarkable news about Sprycel cessation is that all 3 patients had failed
0 L, n; D+ A0 v, V6 rGleevec and Sprycel was their second TKI so they had resistant disease. This is; X( w: A- n* C3 v' w, B& n8 p
different from the stopping Gleevec trial in France which only targets patients$ v' X% i1 n; e
who have done well on Gleevec.' a6 T7 y# \" J2 P; G& T# c. s" F
8 ~! G$ A, @1 d, YHopefully, the doctors will report on a larger study and long-term to see if the' g6 R4 K" |% a7 ?' {$ a$ W
response off Sprycel is sustained.
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Best Wishes,
0 j. c& {% D D5 O0 G8 vAnjana+ V/ X: V* c+ ~' G, `6 i a6 u7 o
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' \9 W4 ]. X. b8 F# J, d$ j& r
* T5 r+ A3 k R& h' Y4 j8 X ZHaematologica. 2011 Aug 9. [Epub ahead of print]
! E* m. e# p W5 j: s9 z9 X4 [Durable complete molecular remission of chronic myeloid leukemia following
$ n, l+ r6 }" `+ S( M- odasatinib cessation, despite adverse disease features.6 ^5 n% L7 P. @( A5 K
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.4 m+ Q. I) }2 n* a2 P
Source7 ~& B9 f5 f# S% B" j7 J% h. w
Adelaide, Australia;* a; d% I: W6 g! ?
5 }' w G6 \# Y8 yAbstract" S; l# u& ]9 r1 L4 Z
Patients with chronic myeloid leukemia, treated with imatinib, who have a
" g( n9 ?0 S1 }! Z( }durable complete molecular response might remain in CMR after stopping3 @8 g0 q0 [2 R' X1 s7 Q7 k
treatment. Previous reports of patients stopping treatment in complete molecular
, M! y# A9 k" e: y L3 Wresponse have included only patients with a good response to imatinib. We
* L: r6 n. S, Z9 s, T6 Rdescribe three patients with stable complete molecular response on dasatinib
$ N) y7 o2 |+ S9 [6 f" Rtreatment following imatinib failure. Two of the three patients remain in2 ?- X' @' q9 _
complete molecular response more than 12 months after stopping dasatinib. In3 o6 J( l( l6 L
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to, j4 P" X1 n# @, J! I% n
show that the leukemic clone remains detectable, as we have previously shown in8 l5 w% X# F+ w+ q' l
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as2 Z& ^% w8 ~% e) V' z; f: ?
the emergence of clonal T cell populations, were observed both in one patient- y) N# m* X1 A& f
who relapsed and in one patient in remission. Our results suggest that the i; i4 F e5 q* Z5 d
characteristics of complete molecular response on dasatinib treatment may be
% x+ u, u7 G- d( @" j3 `+ \8 [ csimilar to that achieved with imatinib, at least in patients with adverse
& N: k7 \5 }3 p6 ]+ m4 x$ ^disease features.
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