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。: o) H5 V4 }7 R5 h* \
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。' {* L/ X' h7 ^8 f
) d& D" z* e4 I" c6 Y作者:来自澳大利亚6 C8 G/ H- g; V0 y3 `- T2 @7 G3 g" y, P
来源:Haematologica. 2011.8.9." f, a4 r; W+ `4 F, T6 w
Dear Group,# H- l% [0 k8 u' m& j& r. e
6 y7 J& g+ s- S7 e2 B) h! Z+ J }5 \Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML" ?& L# ~+ k. R: I0 f, ?
therapies. Here is a report from Australia on 3 patients who went off Sprycel1 \) F( g0 S& _5 ~
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
3 S" ?, m" {5 W# G _! |4 gremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel" e* @* _1 C, ^- @- f$ b
does spike up the immune system so I hope more reports come out on this issue.
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( s- V$ R7 d- Z8 l8 DThe remarkable news about Sprycel cessation is that all 3 patients had failed. K: R d! ~+ S/ R; a
Gleevec and Sprycel was their second TKI so they had resistant disease. This is3 I# {' H) o3 Z: d: s
different from the stopping Gleevec trial in France which only targets patients
i U, X5 i Jwho have done well on Gleevec.
5 z6 ^5 y' a6 `5 L9 o; }7 p3 d/ j* v7 P
Hopefully, the doctors will report on a larger study and long-term to see if the! V9 }+ H* g% Z( O+ }& b+ @
response off Sprycel is sustained.
* _8 X5 X9 a, Z6 C7 E- v, @, i6 R1 [$ N' O; q1 @. P
Best Wishes, a, B: F! e' J3 a9 V+ b* p
Anjana- R9 X5 R7 p/ v
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/ W- p$ L2 a+ Z
( z9 Z. p+ y( l3 w6 A1 s- I! SHaematologica. 2011 Aug 9. [Epub ahead of print]
. @) q! |7 }" i& P t0 _& ?$ q" k3 c# LDurable complete molecular remission of chronic myeloid leukemia following6 A3 K$ A5 g! a m; `" {$ Q
dasatinib cessation, despite adverse disease features.; g! K3 Y7 m1 A9 J7 ~2 S
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.( A: A( j1 p4 t' Q- u. {1 I0 ]
Source
$ _8 b1 \6 n, D; F6 I, o: B) T, ~Adelaide, Australia;
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3 K! G$ q, f. v. k* |Abstract
: [! l! D. c# y8 ]Patients with chronic myeloid leukemia, treated with imatinib, who have a- [8 t/ {% q9 E5 ^/ ?
durable complete molecular response might remain in CMR after stopping& c4 j( n1 ~9 C
treatment. Previous reports of patients stopping treatment in complete molecular# y3 R: k$ L4 ]
response have included only patients with a good response to imatinib. We
8 P C0 e5 m& y8 m, v- W5 Tdescribe three patients with stable complete molecular response on dasatinib& Z3 Y3 E9 @4 Z% |! J
treatment following imatinib failure. Two of the three patients remain in
( U, {. U$ \" K9 J3 ^1 \! scomplete molecular response more than 12 months after stopping dasatinib. In
+ Y+ y f7 ^; sthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
5 Z7 E$ Z3 n8 I" u; o/ i* e7 Jshow that the leukemic clone remains detectable, as we have previously shown in
4 A2 g8 L* p7 r1 }7 B, Kimatinib-treated patients. Dasatinib-associated immunological phenomena, such as; s1 o6 C4 ]4 j6 w/ Y8 ~' L% t
the emergence of clonal T cell populations, were observed both in one patient6 k& k3 c9 [/ K( s: P
who relapsed and in one patient in remission. Our results suggest that the
1 x+ p5 [. R! W3 |* z& E! c' A hcharacteristics of complete molecular response on dasatinib treatment may be$ g# e2 j; K# L& {
similar to that achieved with imatinib, at least in patients with adverse
: {% A4 u; \- \$ x7 Y4 t: Z9 vdisease features.0 Q# N; k! r# n: i( r) l1 e
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