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。

) U2 P; R/ A; t; N; e6 b作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,
' ]: e1 V. ]# ^9 k( ^' q4 M
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
- v" F0 l3 \& f( f7 jtherapies. Here is a report from Australia on 3 patients who went off Sprycel
) S0 V5 g, H7 o% L0 g/ hafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
9 c/ V+ O2 j& F7 [% u" N) d" Zremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
does spike up the immune system so I hope more reports come out on this issue.

2 d) U8 G" R+ @+ {The remarkable news about Sprycel cessation is that all 3 patients had failed
Gleevec 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
4 B, x! ~( r  c5 o  Z2 U& Ywho have done well on Gleevec.
  e+ h! J4 @$ F4 Y8 ]
$ l8 @! T, d3 `" z  T9 oHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
( ~- b* R' U$ }* w, Q$ X" Z
Best Wishes,
Anjana
$ D6 x; L3 L* o* w
! `: u4 v3 q# R/ V

, ]1 @/ I* M5 P( ?/ w* H% oHaematologica. 2011 Aug 9. [Epub ahead of print]
' J( a! }. x4 C, \Durable complete molecular remission of chronic myeloid leukemia following
$ J2 q+ e& v4 C; |: T3 n% A  ldasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
) M" x- U+ F" x) ]Source
7 [: s. K0 J2 R8 C4 d, I' f/ n( f8 WAdelaide, Australia;
  I0 v! s1 Q& |& n, J" @
3 T) P1 L/ p: C) g; l3 qAbstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
0 k3 C( U/ {: {: w8 Q5 k: ?- Ddurable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
+ V) ^$ N1 @# x! {* N) h" Vresponse have included only patients with a good response to imatinib. We
5 q9 [& y& H! G+ idescribe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
, N- o! \6 g# ^0 v6 ^  fcomplete molecular response more than 12 months after stopping dasatinib. In
; i2 F6 \) }. d2 h) tthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
0 m! u& w* ?  V( Z' f% wshow that the leukemic clone remains detectable, as we have previously shown in
9 X/ F$ j) g! u5 p3 nimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
who relapsed and in one patient in remission. Our results suggest that the
7 D( b$ z# h% E+ @. Q' L- tcharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
& e6 x9 c; X9 x7 s& ^' C: edisease 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。
    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。
8 R4 Y9 [# {9 ^$ x
作者：来自法国STIM试验
- m0 j9 K* s! |, x* k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