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。4 d' s+ @4 m3 S# d4 e8 t% r
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
% n6 a: F7 A# K. L来源:Haematologica. 2011.8.9.
, C0 X) q! y: K" j% }. NDear Group,& w+ ?3 Z3 _& P) k8 j
* e: N# M$ q* i) B4 NSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
A" |8 d# {' [/ k% Ytherapies. Here is a report from Australia on 3 patients who went off Sprycel
% B% M) ?( `# safter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
$ e3 s+ e Q/ R2 Aremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel/ N' w& w/ z3 Y: {1 N. {
does spike up the immune system so I hope more reports come out on this issue.! F6 z8 b N" `& ^ ~% B! c1 T/ b
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The remarkable news about Sprycel cessation is that all 3 patients had failed
1 ]. M5 M, g8 Y" NGleevec and Sprycel was their second TKI so they had resistant disease. This is0 ^$ f3 u R. V4 Z
different from the stopping Gleevec trial in France which only targets patients7 G6 o+ |* _) ^6 T
who have done well on Gleevec./ c/ V/ s3 w: `% A; B1 s& X" e
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Hopefully, the doctors will report on a larger study and long-term to see if the
( x# r/ q2 \& ~3 J% N/ W. lresponse off Sprycel is sustained./ O+ P2 `% V2 p$ k
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Best Wishes,/ U% v& C( H L+ `; c. S
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]/ M, t C( g8 y( z/ X& a
Durable complete molecular remission of chronic myeloid leukemia following
. X9 C4 w3 n) w4 W9 v' j9 S; Wdasatinib cessation, despite adverse disease features.4 j$ @8 f' d* b1 P5 q
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
/ ~9 _( T; E# j" _$ s3 ^& Q- K6 rSource
# `! n/ v) Z2 ]6 Z% U7 gAdelaide, Australia;( U, F [# ^! Y' a( M
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Abstract
" s' c% M0 _; z/ y: K. K8 qPatients with chronic myeloid leukemia, treated with imatinib, who have a
. P4 J7 h0 l) ^0 ydurable complete molecular response might remain in CMR after stopping1 ^3 r) {+ [# Q2 h3 L. t* q/ O
treatment. Previous reports of patients stopping treatment in complete molecular
% C( c( r, v. P0 A9 W$ J$ |- Mresponse have included only patients with a good response to imatinib. We
' [1 Q9 a5 P7 _7 kdescribe three patients with stable complete molecular response on dasatinib
% @+ T/ C) `4 `" I/ \" r4 ytreatment following imatinib failure. Two of the three patients remain in
2 ^5 F$ m* E9 U3 Z$ P Wcomplete molecular response more than 12 months after stopping dasatinib. In
8 q s& J0 `) `these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
: R3 ~. t6 k! c, {show that the leukemic clone remains detectable, as we have previously shown in
~4 W8 t% A2 Limatinib-treated patients. Dasatinib-associated immunological phenomena, such as
% J1 ]* q% ^" R6 P6 m% Z& kthe emergence of clonal T cell populations, were observed both in one patient
0 {0 v1 K5 {7 G' C _who relapsed and in one patient in remission. Our results suggest that the& q4 q8 U e+ R/ b
characteristics of complete molecular response on dasatinib treatment may be* D ~8 H* z* z( u5 L5 N
similar to that achieved with imatinib, at least in patients with adverse
: j, H+ S" ~5 D8 vdisease features.
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