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。/ D, _/ v3 H6 A% ~" i( ?
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
& a' Y. `' F9 ~+ R来源：Haematologica. 2011.8.9.
4 D9 m' K5 y! FDear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML0 S8 T0 v# ~ @% _; e4 k
therapies. Here is a report from Australia on 3 patients who went off Sprycel2 A& U. |/ n2 x7 R
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients' r/ M! u5 s1 k) s
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel+ {- V7 ]: ^& W3 X' \4 ]
does 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
. i& a- E4 {( k# @; [Gleevec and Sprycel was their second TKI so they had resistant disease. This is9 h# G+ g" t7 J# w7 t
different from the stopping Gleevec trial in France which only targets patients
( M9 ]( e: V- z3 A! qwho have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the9 C4 C) A; d7 k4 m+ C- L7 @' z
response off Sprycel is sustained.
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Best Wishes," }9 ^/ N$ z7 R/ o
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
" o$ f+ K3 v4 P) p; Z. qDurable complete molecular remission of chronic myeloid leukemia following% s, V7 M& i; r& f2 [
dasatinib cessation, despite adverse disease features.2 X- h. U1 O( R, @4 q3 |
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP." X* o3 @5 k9 |' y q# n" R* k! z S
Source# \- B" [: n+ n) y
Adelaide, Australia;1 W9 c+ x8 P. A( x% [
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Abstract e( U. D# b; h
Patients with chronic myeloid leukemia, treated with imatinib, who have a1 T, |" `1 V; y7 x, ]
durable complete molecular response might remain in CMR after stopping
7 T9 i4 G$ u4 u* W8 ltreatment. Previous reports of patients stopping treatment in complete molecular
9 {: i3 Q8 A, G2 K. Bresponse have included only patients with a good response to imatinib. We
6 ~# K, d5 O. O( s; Jdescribe three patients with stable complete molecular response on dasatinib
( x' C( E! W0 D; ztreatment following imatinib failure. Two of the three patients remain in E0 e4 o8 `3 Q- r$ O# D ?
complete molecular response more than 12 months after stopping dasatinib. In
- O2 X: A, u2 g1 ?3 Zthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to) @, |( l* O6 m2 S; @ V, a: Z+ x
show that the leukemic clone remains detectable, as we have previously shown in
: b% O& r, m9 kimatinib-treated patients. Dasatinib-associated immunological phenomena, such as7 x$ D' Q3 `! c# q7 k: O7 o
the emergence of clonal T cell populations, were observed both in one patient
0 N! D, c! S- \% `) Owho relapsed and in one patient in remission. Our results suggest that the
4 S" P H) j+ S9 Acharacteristics of complete molecular response on dasatinib treatment may be
& x4 a. o4 k( Lsimilar to that achieved with imatinib, at least in patients with adverse$ @8 D# d: k, t0 V1 }/ |: G) ^; g
disease features.
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