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。
1 |0 z/ U, w5 ?7 T6 P" L 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
1 n& z; l. V' H) G1 S: L3 _来源:Haematologica. 2011.8.9.; N! _0 p. y: {' @3 A* Q- @
Dear Group,8 S+ m7 h* j8 |, R5 @ I6 d
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML: J9 S& p0 Z: k( |
therapies. Here is a report from Australia on 3 patients who went off Sprycel
; H, z# N1 M3 nafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
7 i# c" |& d% c6 \9 U" a' s& T4 Zremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
6 c1 U+ T l6 t9 ~. R! y6 @does spike up the immune system so I hope more reports come out on this issue.
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5 k: x) r2 A3 M/ q% lThe remarkable news about Sprycel cessation is that all 3 patients had failed
\% @8 E) Q8 BGleevec and Sprycel was their second TKI so they had resistant disease. This is
9 c- B3 d3 L4 h) Edifferent from the stopping Gleevec trial in France which only targets patients+ ~+ {3 \( M7 v* u m* B8 b
who have done well on Gleevec.
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# Z# [( ^- t' P% I8 wHopefully, the doctors will report on a larger study and long-term to see if the; x6 T0 V3 @/ W+ ^6 ^) `
response off Sprycel is sustained.3 i1 Y4 q/ J" n0 h. P' h5 j! k
3 p& g4 |1 b2 M( Y* v! E( n* xBest Wishes,
8 f: w+ y' k# _/ u. yAnjana
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; ?7 p, l0 i2 OHaematologica. 2011 Aug 9. [Epub ahead of print]2 K k8 l9 t; G6 `# @
Durable complete molecular remission of chronic myeloid leukemia following V# {) X) y; r7 p
dasatinib cessation, despite adverse disease features.& t/ s3 k8 `( P: ]- { z% s
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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Adelaide, Australia;
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Abstract
% O; [9 t: U2 I' SPatients with chronic myeloid leukemia, treated with imatinib, who have a
' @/ i; d) s9 S- f6 gdurable complete molecular response might remain in CMR after stopping
4 O0 n$ {# T- z4 B. w# d$ A Etreatment. Previous reports of patients stopping treatment in complete molecular8 \4 j/ N4 t J" g% i2 s
response have included only patients with a good response to imatinib. We
+ ~& r* E/ s( ~$ h. Rdescribe three patients with stable complete molecular response on dasatinib1 X) t+ k2 O$ ` N
treatment following imatinib failure. Two of the three patients remain in0 i3 L# P i4 L8 Z$ M; m
complete molecular response more than 12 months after stopping dasatinib. In
. \; J- E0 d4 n0 q' r' Z% g! Z% m! rthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
* H7 V( s7 _, n1 jshow that the leukemic clone remains detectable, as we have previously shown in8 q! S- A7 M) b0 Y. l& L" S$ z# U
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
2 L) k5 Z8 m0 S8 {$ e: z) Vthe emergence of clonal T cell populations, were observed both in one patient K7 G9 V: Q4 |+ c7 |( I' r
who relapsed and in one patient in remission. Our results suggest that the, T+ g! D" u# d5 h5 q/ ~
characteristics of complete molecular response on dasatinib treatment may be
0 y2 h# }; R# ?" V" j, o2 zsimilar to that achieved with imatinib, at least in patients with adverse6 \; t! d P& T( q$ n% Z/ J/ P
disease features.
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