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 c/ u3 R6 J( r. ^' i, S/ T
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。2 A; W1 N" _0 M
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作者：来自澳大利亚: y$ r t- L. \* }
来源：Haematologica. 2011.8.9., E7 J- B6 q F3 o- c
Dear Group,- V2 A& J5 S d
( B6 ~' A, ?: @3 k& O) {: z+ ~' ]
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML5 {; D) u2 H* U2 y! u2 {
therapies. Here is a report from Australia on 3 patients who went off Sprycel
: y( s' R' \7 p& nafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
6 N C0 Z. j) o* O' V; Gremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
: @3 q% D4 d' t+ J3 S: Y& ?6 E& ddoes spike up the immune system so I hope more reports come out on this issue.
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The remarkable news about Sprycel cessation is that all 3 patients had failed+ C* I% ~1 a& v8 m
Gleevec and Sprycel was their second TKI so they had resistant disease. This is" g4 P1 o2 C$ s' q: a' C' `3 X! h% h W
different from the stopping Gleevec trial in France which only targets patients6 J. S8 p3 q! {8 C% S# p% n% D3 q
who have done well on Gleevec.
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3 ?- H0 H" ~, DHopefully, the doctors will report on a larger study and long-term to see if the* q/ A& n) Q% s+ T% k
response off Sprycel is sustained.
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Best Wishes,
' Y: W( t0 h7 |7 {3 K7 mAnjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]0 E) d" G. P* o' ?, a: Z) x; L) o
Durable complete molecular remission of chronic myeloid leukemia following# n- \; K8 f" P
dasatinib cessation, despite adverse disease features.
6 }5 e: }& F& F' ?4 CRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
$ p# T3 ^; Y* u s8 [Source
: g9 d# ?2 N) P M4 ]: ^Adelaide, Australia;
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9 o8 d1 |$ t" y2 P h$ `Abstract0 x% m3 ]' W# G+ D
Patients with chronic myeloid leukemia, treated with imatinib, who have a0 x6 `1 }& B1 n' z. p
durable complete molecular response might remain in CMR after stopping
: P; D# B3 V( ?5 A3 n5 vtreatment. Previous reports of patients stopping treatment in complete molecular0 R& f2 \. W- s- {7 X/ f
response have included only patients with a good response to imatinib. We
; _2 m- h7 P# V9 s$ a2 ?+ Rdescribe three patients with stable complete molecular response on dasatinib
7 |: C8 m) A5 i9 Mtreatment following imatinib failure. Two of the three patients remain in
8 ^4 N% A3 o: q0 T8 L9 M Kcomplete molecular response more than 12 months after stopping dasatinib. In
, N1 ^4 Z( h) \) F( i0 Tthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
/ z& n$ Q( ?0 _show that the leukemic clone remains detectable, as we have previously shown in
; J4 N% T- s1 ]/ _3 e2 c! jimatinib-treated patients. Dasatinib-associated immunological phenomena, such as- R0 U- x/ m5 R8 X' `3 @5 [3 N+ |
the emergence of clonal T cell populations, were observed both in one patient' x2 D, i4 z( d9 D" Q* Y1 p
who relapsed and in one patient in remission. Our results suggest that the
3 f; c" U9 ?3 g; R; j5 X+ Y; mcharacteristics of complete molecular response on dasatinib treatment may be
( e4 X. j( N! c. fsimilar to that achieved with imatinib, at least in patients with adverse. i a" G7 F/ u& ? k+ p/ h
disease features.
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显身卡
