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。
) Y0 J" y0 T% u8 n5 b 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。: i( ?8 U# q8 Y3 K
: u) j" O/ C4 e1 l作者:来自澳大利亚8 s7 K% P1 p* W
来源:Haematologica. 2011.8.9.
1 W; c9 k* }) R9 }4 ]0 i) ?! [Dear Group,0 y9 o5 s0 R9 I- c
7 W- H& N* {; z# @- L6 Q p# vSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
( |! d ` A3 b( ?8 ?: Gtherapies. Here is a report from Australia on 3 patients who went off Sprycel* a: J1 T5 z$ c) ` W: j6 \
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients% p1 @1 n0 ^- j( Y0 x. B$ `! z# n
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
) R* |" q2 q( h" W6 ^2 fdoes spike up the immune system so I hope more reports come out on this issue.! r4 x" O% g- }2 ]7 n; [0 V
) ^; a' |" B1 {The remarkable news about Sprycel cessation is that all 3 patients had failed
% H0 w2 y: l) s: L; aGleevec and Sprycel was their second TKI so they had resistant disease. This is: J2 X" t/ _, h/ F Z2 r$ V9 F0 R5 G
different from the stopping Gleevec trial in France which only targets patients
. E' O3 U- q& m+ ^who have done well on Gleevec.7 Q2 C% l! K0 f& M6 g# j6 W1 e( O
& T$ g# D6 N) t. ^2 i) L L8 O
Hopefully, the doctors will report on a larger study and long-term to see if the
5 M7 ~) ^$ C' Lresponse off Sprycel is sustained.. W8 \ x( x# u2 V, Q
2 s! [5 V5 M; U! I; aBest Wishes,
0 |8 P& @* `: t2 r* XAnjana
0 N* V+ R! T' a* |8 w& E; j* V( o1 N$ J. {) z
6 j3 H* p! x0 H+ f6 c' h
- `6 h" u; N+ a4 y% b4 W) ?Haematologica. 2011 Aug 9. [Epub ahead of print]
v+ z! ?& X) X/ [) D" \) } E4 y+ DDurable complete molecular remission of chronic myeloid leukemia following
. {7 v0 P9 p1 o" z6 f+ S ydasatinib cessation, despite adverse disease features.
% p( @) }# a) b q; F3 k) N8 nRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP., |/ P5 h8 z( v1 U% R2 r, ^+ m& Z
Source
& f$ _3 ~0 p. c3 F" t3 H0 a1 N/ MAdelaide, Australia;
3 ^' k g# R& F, r9 s
3 k/ N9 R6 E- W/ Z5 p+ n$ IAbstract I9 q9 a8 J5 X- h M. E
Patients with chronic myeloid leukemia, treated with imatinib, who have a
; W5 J$ ?$ j3 i1 {durable complete molecular response might remain in CMR after stopping1 R" l1 z* r, m
treatment. Previous reports of patients stopping treatment in complete molecular4 u& m; q" t1 t9 n6 b9 r* t
response have included only patients with a good response to imatinib. We
$ R! \) u# N: ]- C5 fdescribe three patients with stable complete molecular response on dasatinib
6 t. q1 [2 J! etreatment following imatinib failure. Two of the three patients remain in
[/ `; o6 W, j, a% C! ccomplete molecular response more than 12 months after stopping dasatinib. In
" M% {* r' U( |" ^6 L( A" ethese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
0 O6 o* Q3 ]$ u. u/ `, a; pshow that the leukemic clone remains detectable, as we have previously shown in
Y& U$ F$ d* ?, Vimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
; q3 ^' G# K! Y) fthe emergence of clonal T cell populations, were observed both in one patient
X7 a7 g4 h* w& ]who relapsed and in one patient in remission. Our results suggest that the9 S# m5 q! R: d$ T8 B3 ]
characteristics of complete molecular response on dasatinib treatment may be
4 {2 t+ X, ^" U- v& s3 m; f( osimilar to that achieved with imatinib, at least in patients with adverse
- P+ h8 P: t% A( F+ Bdisease features.* G) t" {6 {) |8 f4 B: Y' f
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