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。
3 v" N" l# `5 r* r  c% M) v    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。
# J. ~0 A7 D3 A2 y
3 ?; V# W$ r" z作者：来自澳大利亚
/ B0 [* U; n, ^/ n6 |) a来源：Haematologica. 2011.8.9.
Dear Group,
& X) O! J- I  s9 \4 p+ b
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. Here is a report from Australia on 3 patients who went off Sprycel
9 L# I" G4 W% S: g- N1 u1 R  Jafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
0 x- R$ b1 }+ \$ \* e/ a* eremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
! A9 }( P. k& ^" K/ f) f& j# fdoes 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
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
different from the stopping Gleevec trial in France which only targets patients
% J5 H0 H% M' N+ R. ^2 i( Dwho have done well on Gleevec.

Hopefully, the doctors will report on a larger study and long-term to see if the
, z$ Z1 S9 \' r  c. z$ t6 wresponse off Sprycel is sustained.

Best Wishes,
Anjana
6 {) n0 d  G+ o# ?7 \6 m/ ?


Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
* f' V1 j0 d3 X5 S# V% i' yRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
) D+ \# v) y! k  @Adelaide, Australia;
+ L2 C) w" [9 |* I& L9 Z( a
Abstract
3 y# p* ]+ F- X) ?2 cPatients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
* j, _/ q1 S. [( Ltreatment. Previous reports of patients stopping treatment in complete molecular
4 Z5 Z# Q2 ~% L% `% _( Jresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
$ _; N  X; g9 ?& U9 q' Xtreatment following imatinib failure. Two of the three patients remain in
/ }) I8 ?  r" i7 ]1 n: dcomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
show that the leukemic clone remains detectable, as we have previously shown in
, q: Y, C, R6 pimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
' ~' @4 Y4 K+ o2 pwho relapsed and in one patient in remission. Our results suggest that the
; U' d, \4 G9 Dcharacteristics of complete molecular response on dasatinib treatment may be
; D! a* I' r  O; Xsimilar to that achieved with imatinib, at least in patients with adverse
disease features.

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。
8 `- o+ X6 s4 R- o, [! R' u6 _    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。

' y3 x1 J# N+ Y1 n2 S3 F2 @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