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。
R$ p; ~- Z+ k+ [2 _ 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。' d' k! P! l# `# X: a9 [/ a
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作者:来自澳大利亚
2 l6 {( W& e! c; g来源:Haematologica. 2011.8.9.
) H8 y0 y' V( ^Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
$ J1 w$ u5 B5 E8 Vtherapies. Here is a report from Australia on 3 patients who went off Sprycel
$ b4 D( R2 i+ l6 A: z3 Fafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients) S9 y" j) O0 r9 u" [4 _
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel' X% b& T! t& y! i9 Q5 D+ }+ K
does spike up the immune system so I hope more reports come out on this issue./ E# z$ j. U! r9 g
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The remarkable news about Sprycel cessation is that all 3 patients had failed
% f! O6 w& x2 u) X- `Gleevec and Sprycel was their second TKI so they had resistant disease. This is% w5 N$ ?* S9 Q
different from the stopping Gleevec trial in France which only targets patients4 ]* ?+ Y! W& r6 J
who have done well on Gleevec.! ?, J2 R; Y3 I; s4 y7 Z% h
7 s& I* x$ @9 x- W& K+ S/ [5 fHopefully, the doctors will report on a larger study and long-term to see if the0 v( T7 z1 ]2 E7 D& R
response off Sprycel is sustained.
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, ~5 j8 F; [$ s i! V1 l" cBest Wishes,
# ~2 S2 b$ g1 r- Y0 {$ o1 ?3 |Anjana
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0 X6 {, Y! Y5 `) nHaematologica. 2011 Aug 9. [Epub ahead of print]
! X' `( }) f. X+ h1 x7 uDurable complete molecular remission of chronic myeloid leukemia following
, D( R" ]% y- K0 a% w" Qdasatinib cessation, despite adverse disease features.: c% Q, l: `: o% x9 f" ~. e
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.0 M9 a( u3 w W% `1 u( t3 E) m
Source' b3 e" j2 F. C2 j2 J
Adelaide, Australia;
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# R3 E) j5 Q4 e9 O. bAbstract
! b7 @' m' C( w. LPatients with chronic myeloid leukemia, treated with imatinib, who have a0 p, i: u5 l; c3 }
durable complete molecular response might remain in CMR after stopping2 o2 g) X$ J/ s) D: m. c
treatment. Previous reports of patients stopping treatment in complete molecular! t2 Y* Y. k) u9 R. Y. v# O+ K: g
response have included only patients with a good response to imatinib. We
/ ^% s% R$ _# D# P6 V Ndescribe three patients with stable complete molecular response on dasatinib
$ D" W. m% F$ b* j# w7 }treatment following imatinib failure. Two of the three patients remain in3 d p" W, U' R
complete molecular response more than 12 months after stopping dasatinib. In
9 h8 y2 @. m: O7 [0 x0 Kthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to9 I. M" ^) o5 V. i& r
show that the leukemic clone remains detectable, as we have previously shown in
- i- K& _+ w4 kimatinib-treated patients. Dasatinib-associated immunological phenomena, such as% g: c8 x: `; o
the emergence of clonal T cell populations, were observed both in one patient
4 u# J& O: q0 i2 Vwho relapsed and in one patient in remission. Our results suggest that the
( `$ K! C# x5 i( g! Xcharacteristics of complete molecular response on dasatinib treatment may be- {4 X/ p. x% j& ^% \6 r5 w
similar to that achieved with imatinib, at least in patients with adverse( e8 q$ ]3 @0 z
disease features.! T; F2 n/ r* E7 n" \: d4 V
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