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。
, P" q& H3 L) C0 g% X/ L, G 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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5 V' l7 {3 t+ d/ e6 E作者:来自澳大利亚
- `3 u1 q5 E, l来源:Haematologica. 2011.8.9.
; Z9 T0 J- Z5 Q/ K2 i% {Dear Group,0 y% m; E- w% l+ R
5 W& n% Q9 f+ L$ _! z2 GSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML0 o' n) j4 ]: ]* `0 H# Q
therapies. Here is a report from Australia on 3 patients who went off Sprycel' m r k' j! q* [3 a) C: b3 `
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
0 z" { o4 O0 w1 g& U' gremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
3 X7 v2 }/ t; b; U- T! t/ n* @7 Sdoes spike up the immune system so I hope more reports come out on this issue.6 E, C* @+ P, \' O! [7 z
" }& i7 S: s5 }6 @! e$ t {. bThe remarkable news about Sprycel cessation is that all 3 patients had failed; b* U1 S! M6 u# J
Gleevec and Sprycel was their second TKI so they had resistant disease. This is; u7 Y" ?6 S" X* C) a
different from the stopping Gleevec trial in France which only targets patients; j" ^# `; S9 A( B* V
who have done well on Gleevec.! L, S9 E: K/ u2 S2 k+ g
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Hopefully, the doctors will report on a larger study and long-term to see if the0 }" ~! I% E: h% M# x
response off Sprycel is sustained.
" m( n4 o. s& y
4 U9 j- |" J3 m4 _. {Best Wishes,5 B5 T: |' N7 H& E
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print], j l6 n) u) B5 N# n
Durable complete molecular remission of chronic myeloid leukemia following. ~/ Q$ x* @3 \ m; l3 C u! p
dasatinib cessation, despite adverse disease features.
, o/ s |3 h) s$ ]; f; E+ @' [7 `Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
- E. J( G. A6 q( S) N% mSource
, b6 p1 ^) F7 [% QAdelaide, Australia;
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Abstract& Z9 J0 A7 n; i! v8 r% s2 u5 {
Patients with chronic myeloid leukemia, treated with imatinib, who have a
2 o" v4 h E; g. f% t. R4 v$ Fdurable complete molecular response might remain in CMR after stopping
3 Y8 w, A3 R& n4 U6 W3 b& A5 vtreatment. Previous reports of patients stopping treatment in complete molecular4 S' i9 P0 ^; R' T1 y) C" P6 C7 N% G
response have included only patients with a good response to imatinib. We
2 U! E K/ K" adescribe three patients with stable complete molecular response on dasatinib' ]. T0 U9 a& X
treatment following imatinib failure. Two of the three patients remain in0 D. G) ]1 y6 t/ n3 h
complete molecular response more than 12 months after stopping dasatinib. In! k( X% K7 {. f6 g* q# F
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
) O; ?' l4 N. Q* Ushow that the leukemic clone remains detectable, as we have previously shown in
' H; o* c8 K2 Nimatinib-treated patients. Dasatinib-associated immunological phenomena, such as' O' |/ t- @, @: ], ?9 a. `
the emergence of clonal T cell populations, were observed both in one patient
; w! h% S* z5 c6 G4 Vwho relapsed and in one patient in remission. Our results suggest that the1 K6 J/ V* [& @1 t# j# z
characteristics of complete molecular response on dasatinib treatment may be0 t9 D4 S3 ~$ |6 C3 D# ^" ?
similar to that achieved with imatinib, at least in patients with adverse
+ A% w: I/ p8 c# n* H$ k% h4 Ldisease features.8 ]2 K: q& X H; h, z) E# ~4 w
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