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。/ s) N4 ^0 l" f! C; D2 e' H
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4 _2 F- l6 c. Y1 _
来源：Haematologica. 2011.8.9.
/ q3 N# w; F* t" a2 RDear Group,
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Y+ A8 @9 o3 ^3 T. LSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
. q) s( s' B3 N' ?therapies. Here is a report from Australia on 3 patients who went off Sprycel0 u. t' A* o3 ]3 p4 v
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
& F, S) b- T& }( T( k8 b$ M% j4 Premain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
" J2 U# ]- y$ udoes spike up the immune system so I hope more reports come out on this issue.
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; `& j2 ^1 T2 lThe remarkable news about Sprycel cessation is that all 3 patients had failed( F/ ]( q( E6 g' p0 ^; B f. m
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
! [2 o" ^: y0 \$ o! \9 G+ V9 Hdifferent from the stopping Gleevec trial in France which only targets patients
( V1 L9 _' B1 ~8 x1 d9 vwho have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the
' V0 p4 _ ?& i1 R3 O4 Aresponse off Sprycel is sustained.
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Best Wishes,
. o3 x o9 G3 W4 R* b! }Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
( O& Z8 \& U; }6 }" aDurable complete molecular remission of chronic myeloid leukemia following
& e( e4 ~( H5 _2 xdasatinib cessation, despite adverse disease features.+ ^( a, m' T; {
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.7 X0 d( h3 C' B8 g0 X7 t
Source
% z; ^9 s+ G2 I( rAdelaide, Australia;
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Abstract; x3 o- J X) r0 W6 \6 }& l
Patients with chronic myeloid leukemia, treated with imatinib, who have a
+ K6 W! p: s0 z: b# E; ldurable complete molecular response might remain in CMR after stopping x& `' @& T! G/ O: P
treatment. Previous reports of patients stopping treatment in complete molecular4 t: q2 P" u( Y2 K2 r" R/ A
response have included only patients with a good response to imatinib. We
! M: ? o5 E4 n* \; K0 qdescribe three patients with stable complete molecular response on dasatinib. [! e+ g3 R% h
treatment following imatinib failure. Two of the three patients remain in/ Z$ ]8 h& m# a$ o
complete molecular response more than 12 months after stopping dasatinib. In5 t! J9 I6 [: X5 m4 l
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to" G0 ^9 J6 E8 N
show that the leukemic clone remains detectable, as we have previously shown in9 t4 u0 E: E3 k C. Y
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as1 O# q* Z- ?5 R+ H" K
the emergence of clonal T cell populations, were observed both in one patient9 k5 r9 A5 |. m% L+ O9 l \- {' c- O/ E
who relapsed and in one patient in remission. Our results suggest that the
' }4 i* Y. O) R# E# {characteristics of complete molecular response on dasatinib treatment may be$ Z. N* x- o/ S; K8 p' A; C. D3 v
similar to that achieved with imatinib, at least in patients with adverse, U' W% S0 ?" ~$ P) R+ E6 @
disease features.& i8 ?- C! V8 e, F9 @9 X
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