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。
    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。

作者：来自澳大利亚
6 V4 F4 l% D* k9 H  o来源：Haematologica. 2011.8.9.
Dear Group,

! w/ ^% F( p, s9 q; aSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. Here is a report from Australia on 3 patients who went off Sprycel
* ]1 R2 U: s! u: K6 mafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
% z( c$ U( b5 d1 oremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
1 ^) l/ G" ?- D! l. pdoes spike up the immune system so I hope more reports come out on this issue.

8 E9 J  r3 h# ]- v2 n9 j; BThe remarkable news about Sprycel cessation is that all 3 patients had failed
+ {# E; i7 N4 w* g" gGleevec and Sprycel was their second TKI so they had resistant disease. This is
4 v$ `- \" H4 u* c# odifferent from the stopping Gleevec trial in France which only targets patients
& [# U1 y: @3 O/ |( ]who have done well on Gleevec.
8 {5 p8 v; N4 d- l& }
8 N! k+ b* s) e- @  P6 [& IHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
, E( V1 D0 R& N0 o- A. X
8 f7 j3 R% [+ ?7 N5 I* ^0 dBest Wishes,
Anjana
1 a0 ~! N9 u! o% x3 i

& U% G! L0 ^' C
. Z4 R' x8 [' cHaematologica. 2011 Aug 9. [Epub ahead of print]
; U' I- Y' X' \$ xDurable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
! A7 ]6 t8 C) @/ jAdelaide, Australia;

0 n; p& ], m2 s4 G( Y0 H# U8 y4 gAbstract
0 Q8 s! O2 F$ R* JPatients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
& {! A* w* I& ]3 |! |1 S" v/ l0 vtreatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
/ m* g5 {. F" y) r8 j' @$ ldescribe three patients with stable complete molecular response on dasatinib
; s: Q/ p8 s: B+ Q  htreatment following imatinib failure. Two of the three patients remain in
1 Y% N7 B9 R& s6 Lcomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
show that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
3 q/ q" k9 y2 C; \the emergence of clonal T cell populations, were observed both in one patient
4 c; K! C& d5 i: b% [# h- h7 |who relapsed and in one patient in remission. Our results suggest that the
& o( k/ ?1 [4 Q: ^6 Wcharacteristics of complete molecular response on dasatinib treatment may be
% l/ o  x' R6 m* W: |' @9 qsimilar to that achieved with imatinib, at least in patients with adverse
disease features.
! Z) ]' D" V7 ^# p5 g2 J( \

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。
    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。

" K; X9 E1 B7 A# [/ B# A1 r; S4 a. c$ p作者：来自法国STIM试验
9 Q) _  l9 Q( ~& P& L1 G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