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。
+ e! [" D9 K3 x% b3 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
来源：Haematologica. 2011.8.9.
Dear Group,

) h! H+ m2 E& Q' f; SSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
( f6 L; ]; I# t) ^- Y0 _therapies. Here is a report from Australia on 3 patients who went off Sprycel
7 A/ h( x% b8 W1 h( iafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
- z/ F6 z  p9 R1 m! v; i# ]# gremain 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.
/ i. ~5 T2 a7 K7 U! X; ]' g
7 v: t" M, h; I& u9 x2 fThe remarkable news about Sprycel cessation is that all 3 patients had failed
5 A8 w6 N; j1 }, IGleevec and Sprycel was their second TKI so they had resistant disease. This is
! Q; m( e" G* X2 C  ?9 E/ Mdifferent from the stopping Gleevec trial in France which only targets patients
8 m% H/ a# d1 [7 Twho have done well on Gleevec.
" A; D! X, ~7 j, R4 v+ v' f
! Z; N+ G! G% p' |& k7 `/ sHopefully, the doctors will report on a larger study and long-term to see if the
6 x' x& F' `5 B3 b  dresponse off Sprycel is sustained.

Best Wishes,
6 Z. t  s# Y  i% x( [9 dAnjana
5 `% B# c0 y: q) X
+ j3 w' T/ O. o- T) {2 i4 i
* j( B1 A3 V4 b2 B
Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
5 R+ N) V$ m) o/ ]- w( tdasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
( `' B! l* D% y. LSource
Adelaide, Australia;
0 l/ e1 O* C; H$ c- ~
. |0 h' C" J! v. M( wAbstract
, z2 Z5 M/ b8 P! _# O4 B% U8 kPatients 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
. }. D& C% Y( S. jdescribe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
' }" |4 R4 ~# V/ r1 Ncomplete molecular response more than 12 months after stopping dasatinib. In
7 [) t0 A9 P7 H( }5 W  q$ Athese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
6 B3 V) \- j& k  Ashow that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
, j3 Z# i4 W+ B; w3 ythe emergence of clonal T cell populations, were observed both in one patient
who relapsed and in one patient in remission. Our results suggest that the
1 Y0 `7 f4 v6 ~% N! G* rcharacteristics of complete molecular response on dasatinib treatment may be
# O; Y( z' `7 v9 E( Y5 y: }similar to that achieved with imatinib, at least in patients with adverse
% b/ L1 i! d" udisease 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。
    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。

作者：来自法国STIM试验
0 z% Y. H2 B5 P3 i9 [" k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