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。
) 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。

: u) j" O/ C4 e1 l作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
1 W; c9 k* }) R9 }4 ]0 i) ?! [Dear Group,

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
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
) R* |" q2 q( h" W6 ^2 fdoes spike up the immune system so I hope more reports come out on this issue.

) ^; 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
different from the stopping Gleevec trial in France which only targets patients
. E' O3 U- q& m+ ^who have done well on Gleevec.

Hopefully, the doctors will report on a larger study and long-term to see if the
5 M7 ~) ^$ C' Lresponse off Sprycel is sustained.

2 s! [5 V5 M; U! I; aBest Wishes,
0 |8 P& @* `: t2 r* XAnjana
0 N* V+ R! T' a* |8 w

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.
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
Patients with chronic myeloid leukemia, treated with imatinib, who have a
; W5 J$ ?$ j3 i1 {durable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
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 the
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.

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。
# h& ^7 f6 B- L# H% B    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。
    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。
% ^0 S  v+ r- k/ W8 S5 q3 ~6 K* ?
作者：来自法国STIM试验
; M- v1 D5 @1 {9 A, v# s4 @, D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