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。
    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。
+ }5 {( }& I/ l+ ?$ M/ a
作者：来自澳大利亚
" G6 c9 ?1 Y) @来源：Haematologica. 2011.8.9.
6 R8 a9 t0 l# O3 |0 g5 Q. h; ODear Group,
2 t5 Y6 m" z6 [+ b- |
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
# ?0 w" ~1 T8 Ctherapies. Here is a report from Australia on 3 patients who went off Sprycel
6 [% K& t  E. d$ f' ~. O# d+ Cafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
does spike up the immune system so I hope more reports come out on this issue.
  @$ o4 G; O6 @  x7 C2 {5 q, _6 I) A
The remarkable news about Sprycel cessation is that all 3 patients had failed
  n2 }, A( v( p0 c4 b' g( N% TGleevec and Sprycel was their second TKI so they had resistant disease. This is
, C. U  ~2 S& k# O# \/ n4 V  `' edifferent from the stopping Gleevec trial in France which only targets patients
4 {$ Y7 N: m! Gwho have done well on Gleevec.
; U; N! ^! N+ b1 }5 U
) I5 p% D! O. z4 kHopefully, the doctors will report on a larger study and long-term to see if the
  n: _7 G$ K# N: q* I2 Sresponse off Sprycel is sustained.
2 [/ x4 w( D- j) N
Best Wishes,
Anjana
1 t4 V% B! j& v7 M+ P
' q) m2 j. \4 n

7 `* }& W  I# U! u; N. d1 SHaematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
2 L; h/ o+ n2 C6 ^& \. sAdelaide, Australia;
' B/ f1 Z3 c4 v' M) G
Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
: a5 h" h+ l( W- p# Z0 f0 Otreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
8 N3 N, G4 \2 @8 sthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
9 E6 f: l" Z8 \7 [! h$ |( dshow that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
* }2 [# v* ?. O$ X4 P4 Zwho relapsed and in one patient in remission. Our results suggest that the
7 H9 E' }3 j" {/ [3 {characteristics of complete molecular response on dasatinib treatment may be
# C% f- T9 L3 ]5 Fsimilar to that achieved with imatinib, at least in patients with adverse
2 L& _# ?9 R' G5 I- e; M( x3 q' pdisease features.
4 z; u. Z0 C4 Q- l) {

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。
    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。
/ e% a- ~8 f* R: I4 y
) x0 |9 H: m% H$ ^& O4 m6 u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