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。
5 L* J0 _) z% ?) }: a `6 p 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。7 U6 J& z3 b5 i
6 ]* r+ c* a: Y9 h- s作者：来自澳大利亚
& M# x1 \/ G$ x2 `3 R: Z) N$ U来源：Haematologica. 2011.8.9.
; D/ E1 _; x" H3 t1 `0 Y" i; PDear Group,) {0 x6 q& l1 j1 T/ R+ h
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML3 f0 a. N6 q3 Q" ?" p
therapies. Here is a report from Australia on 3 patients who went off Sprycel# s3 d; M. i& w3 z# Z4 e0 Z
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients% ^6 u2 a; s0 y/ J# H
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
% Q" d$ B' o1 F$ V" {does spike up the immune system so I hope more reports come out on this issue.
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3 F0 W/ O1 W- m0 ^* _The remarkable news about Sprycel cessation is that all 3 patients had failed
$ |: s: T+ P3 D2 ]9 iGleevec and Sprycel was their second TKI so they had resistant disease. This is
* a1 p' {1 v9 E# Bdifferent from the stopping Gleevec trial in France which only targets patients
" O7 D+ o& L3 W: @- G8 R Vwho have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the
2 y& y9 n9 H; C8 z" Q) D8 Q! @response off Sprycel is sustained." J9 R" j8 J% g) S8 R0 U$ |
* t! q# U( U- c) J) z, ~7 T( A; J+ a! nBest Wishes,) W4 W5 d5 X& ]) I8 o! j5 G
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
" N; L! u* M# V) z, kDurable complete molecular remission of chronic myeloid leukemia following
6 |0 u( Y) a* o, x9 x3 }# Pdasatinib cessation, despite adverse disease features.
" [. ?; p. r, SRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP. \# r9 e$ l/ @# m' j. c2 F
Source
0 H: p2 y2 B! y' J0 cAdelaide, Australia;: r8 z! u5 J+ u B# P$ v
8 Y; b& z6 Y$ I4 Q* C. N8 T& B3 h1 TAbstract
3 X% j* v! C# b1 @4 o+ S# lPatients with chronic myeloid leukemia, treated with imatinib, who have a
0 i1 A! r0 ?" S3 ydurable complete molecular response might remain in CMR after stopping5 a; U+ m- i0 m, [
treatment. Previous reports of patients stopping treatment in complete molecular. c2 K1 k, q7 o0 [, |
response have included only patients with a good response to imatinib. We- a4 S" Y5 U9 ^( b8 s
describe three patients with stable complete molecular response on dasatinib3 D: _+ N8 I+ f$ g8 E
treatment following imatinib failure. Two of the three patients remain in" U7 \ o i7 n3 Y/ O7 b
complete molecular response more than 12 months after stopping dasatinib. In
! l0 R- ^3 V, E0 R% s8 e% {these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to4 `" A5 N& ^7 \. w% U
show that the leukemic clone remains detectable, as we have previously shown in! t/ v9 N0 ^& [: l
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
; F6 o8 B( Y# E$ e) F8 Mthe emergence of clonal T cell populations, were observed both in one patient
& \1 ]( S$ @* d3 x8 y+ ]who relapsed and in one patient in remission. Our results suggest that the/ f) H* W6 |1 d3 u9 N" M9 d5 b2 t
characteristics of complete molecular response on dasatinib treatment may be
6 I r3 r$ n! R$ S+ m! R* Asimilar to that achieved with imatinib, at least in patients with adverse
+ Y5 t: a2 r) L) L8 c2 Jdisease features.
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