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。, Z+ @3 t! w1 @1 {6 B
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。. G- `( C( o3 I- y8 w: u
; h; _2 B# c8 v0 i3 ~" t6 C# o4 i4 B
作者:来自澳大利亚& ^0 ^( N4 U5 ^: A) K
来源:Haematologica. 2011.8.9.' N0 P& q2 k+ d6 A: O. U) K
Dear Group,$ T4 g, Q% n3 a. |( Y4 G
* a2 X: I) E; M# {% E2 ^' x: S4 m1 lSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
& Q) v8 r3 F+ l5 @therapies. Here is a report from Australia on 3 patients who went off Sprycel; S' D9 z9 e; R% {0 R9 l
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients4 p" I, W m$ M$ H7 G) G1 _
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
9 g" S3 e4 x; H0 N5 H( Tdoes spike up the immune system so I hope more reports come out on this issue.
4 Y9 r# ~" ~( K0 F9 |7 Q6 P! U1 x$ W4 V
The remarkable news about Sprycel cessation is that all 3 patients had failed7 v V# ~: Q$ R7 ~& U1 f
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
7 |/ ] A5 ]5 f9 o8 _1 J- G7 ^different from the stopping Gleevec trial in France which only targets patients
/ ?' ^$ G+ n$ E# \2 h7 Kwho have done well on Gleevec.: Z y6 Z" [' ?0 }8 C- n
5 q; O- V' o8 a8 r) b! i
Hopefully, the doctors will report on a larger study and long-term to see if the2 Q1 }! a* g. D) `
response off Sprycel is sustained.6 P1 @( P- [' b; }1 h) i
" w; M2 u& p* W* i% s [! rBest Wishes,8 c. t* C/ l; D7 h
Anjana! V5 k1 ]2 n3 w
7 D0 }% W) ]4 B8 l* f
: U. S+ g9 O$ {! Q( A
. F! Q& m$ Y# S. {- ]+ yHaematologica. 2011 Aug 9. [Epub ahead of print] h+ \5 l) c/ R+ `$ }
Durable complete molecular remission of chronic myeloid leukemia following$ O+ d H9 ^" S) `/ e" h3 u* O
dasatinib cessation, despite adverse disease features.& K# a. z* p: y: \5 s* Y0 T4 G; t
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
6 _4 I. h! s2 _% @/ jSource
6 W6 o9 u7 x# O6 C# g0 [2 SAdelaide, Australia;) X9 ~# ^& v) t% z$ Z7 ?
' p( \3 W' U2 s+ q2 OAbstract
4 t5 A3 ]( t4 i/ zPatients with chronic myeloid leukemia, treated with imatinib, who have a
* a+ a0 B; O, F! }* ldurable complete molecular response might remain in CMR after stopping7 k# o1 n2 h9 j6 I0 b4 l8 N
treatment. Previous reports of patients stopping treatment in complete molecular( M( O5 N; i% I* K# l
response have included only patients with a good response to imatinib. We! E; t! Y7 P$ D
describe three patients with stable complete molecular response on dasatinib
! F; d, P3 I6 O* Ftreatment following imatinib failure. Two of the three patients remain in* w. q, `' L% J4 a. l/ `
complete molecular response more than 12 months after stopping dasatinib. In! A! Y" u5 R) E+ I1 l+ ^. X* Z
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to3 h. P' _, j( ~8 \1 A' q
show that the leukemic clone remains detectable, as we have previously shown in
4 l8 d- Z6 t9 F* ]. |5 Pimatinib-treated patients. Dasatinib-associated immunological phenomena, such as" J; H8 Z2 z% v( O
the emergence of clonal T cell populations, were observed both in one patient
: u2 U3 M6 _& twho relapsed and in one patient in remission. Our results suggest that the9 l6 E- z' {* ?5 D
characteristics of complete molecular response on dasatinib treatment may be
# l0 s; X# W& e( Asimilar to that achieved with imatinib, at least in patients with adverse; i! }/ g% L1 k# s9 z
disease features.0 q. ?- l: h& N% L: b" Y! I5 u
|