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。8 S, W# O3 @1 D' F
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。" U# P) N9 j* B
2 |* b1 p5 {& A2 [作者:来自澳大利亚8 ?) o% V; r- T. q; [
来源:Haematologica. 2011.8.9.9 p8 G# y1 ~( C1 W& G& |/ u1 H3 e
Dear Group,) e8 e# q! B U5 v& e
& g; L, `) ^: l K! ySome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
6 m" N) l; T- G# `5 c) e+ Ltherapies. Here is a report from Australia on 3 patients who went off Sprycel
- h6 x3 p2 |- }6 X3 J$ nafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients' u" I- s/ V* @
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel7 W! V* i2 z4 f, H P
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 failed1 e. f* r% k7 c2 j
Gleevec and Sprycel was their second TKI so they had resistant disease. This is" n2 P7 m* O* {# J
different from the stopping Gleevec trial in France which only targets patients. v0 r, f, Y" [/ X! C
who have done well on Gleevec.3 o: B& n. @: Z) E4 ^; ^
. f+ w Y2 a |. v0 aHopefully, the doctors will report on a larger study and long-term to see if the; w9 Z3 @! ~, G. V, Z
response off Sprycel is sustained.
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Best Wishes,' \$ f. q0 U5 u; O& {. A
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
3 x* D T$ S. i- J% A5 w' TDurable complete molecular remission of chronic myeloid leukemia following
" e' c8 `% Y* \" M1 L) v$ udasatinib cessation, despite adverse disease features.
8 M3 F" H+ f" z# ] PRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
- Y7 y$ `7 C3 ?0 eSource! x9 S; l; H/ o+ v
Adelaide, Australia;8 m% e' g! ], \5 K$ _$ h8 ^
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Abstract j1 y6 B! u2 }" B" q, ?8 }
Patients with chronic myeloid leukemia, treated with imatinib, who have a
" r) G4 K5 g# y) Adurable complete molecular response might remain in CMR after stopping
, _1 o1 J0 d# H8 T2 O) b& d/ streatment. Previous reports of patients stopping treatment in complete molecular7 {& \9 U9 H- u( O; G- l
response have included only patients with a good response to imatinib. We' N& _) W. q& E ]5 i0 Y7 L2 s
describe three patients with stable complete molecular response on dasatinib/ I* A0 ^) q7 B3 r( q5 B1 }
treatment following imatinib failure. Two of the three patients remain in
! F+ c4 z" p3 Mcomplete molecular response more than 12 months after stopping dasatinib. In
9 B; M+ }( P! fthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to& }6 n! r$ u3 E( X# O
show that the leukemic clone remains detectable, as we have previously shown in
3 P6 L+ [* ~) aimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
1 L+ p2 U h$ Sthe emergence of clonal T cell populations, were observed both in one patient
0 o; S) g$ e x( t5 ~% q) ]4 i5 O3 vwho relapsed and in one patient in remission. Our results suggest that the+ p M; U( ]$ i/ @. c; `
characteristics of complete molecular response on dasatinib treatment may be) [- G* f1 ?! @+ F* \/ H* \& z
similar to that achieved with imatinib, at least in patients with adverse5 @8 Q4 Y7 d/ c
disease features.' e' P5 D% B& g1 r: e# D$ v3 F
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