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。
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作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
: h0 b# ]4 l, q! X- k4 |7 t9 Qtherapies. Here is a report from Australia on 3 patients who went off Sprycel
/ b0 ~% }2 c  ^) h& Eafter 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
does spike up the immune system so I hope more reports come out on this issue.

The remarkable news about Sprycel cessation is that all 3 patients had failed
0 v7 t4 N; |" k! q# J" B) SGleevec and Sprycel was their second TKI so they had resistant disease. This is
4 j: }& ]' g; b+ y2 idifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
; V% y' L" t3 e7 A# Z
) Y! J9 V2 W& a% `' P9 CHopefully, the doctors will report on a larger study and long-term to see if the
' R% v! A7 N  N! e$ D9 T3 Uresponse off Sprycel is sustained.
% q  O5 r. N' C0 s' [
5 l& S" v" z% p1 Q: g# Q7 yBest Wishes,
9 Z2 j9 \, z8 e% ?3 Q- ~: AAnjana

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. l1 @) t! E& k% M6 d, `  H- XHaematologica. 2011 Aug 9. [Epub ahead of print]
$ ?7 C$ J9 j! U% O* z7 |3 rDurable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
/ w, y) X, B: R+ w& QRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
5 t* h2 P# Q7 b2 j4 ]7 q/ _Source
Adelaide, Australia;
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Abstract
! l  o& H! b/ hPatients with chronic myeloid leukemia, treated with imatinib, who have a
# X0 Z$ Z% j8 e8 }3 mdurable 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! H5 O4 i0 Jdescribe three patients with stable complete molecular response on dasatinib
8 F) t; Q: g- s) ^treatment following imatinib failure. Two of the three patients remain in
. o8 u0 m2 B( V0 J" @4 I. ^* hcomplete molecular response more than 12 months after stopping dasatinib. In
: \  P# {4 @! Z$ O3 Y( L& ethese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
0 Z+ K% f$ d, b; Z4 Zshow that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
: Q; z' |9 f2 j, Rthe emergence of clonal T cell populations, were observed both in one patient
3 B+ p# \  ^) c# `who relapsed and in one patient in remission. Our results suggest that the
3 q- ^. ]* Z3 @5 acharacteristics of complete molecular response on dasatinib treatment may be
3 K3 f6 `+ a% M, \! l) fsimilar to that achieved with imatinib, at least in patients with adverse
disease features.
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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。
+ `+ W4 B& `" Q1 S  ~- q    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。

; T6 R7 I4 S" g作者：来自法国STIM试验
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