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。2 a% P; L3 w+ V. v4 C" d) A# Z
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。; A% y8 o; t7 N" o5 B. X2 _
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作者：来自澳大利亚8 ]* i# Y/ u$ {7 ` J5 |" ]
来源：Haematologica. 2011.8.9.8 e0 [0 J( i* f2 ^7 d" R. N) Q1 }
Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML! h3 i% _* U7 S, y" S& [
therapies. Here is a report from Australia on 3 patients who went off Sprycel
4 o( H7 ]2 w' s; Z0 }after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients! z( m% H' ]* r6 h6 E
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
( R- M. f" ?% B# \( o2 j- Q) t7 ddoes spike up the immune system so I hope more reports come out on this issue.
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9 M0 L: e) J( uThe remarkable news about Sprycel cessation is that all 3 patients had failed3 A( A3 K4 ?% } A7 B
Gleevec and Sprycel was their second TKI so they had resistant disease. This is( n4 i1 R, V4 e/ }, P% R
different from the stopping Gleevec trial in France which only targets patients( M6 r0 x0 v- Y, Z5 c
who have done well on Gleevec.& J- Q8 ~7 h* P1 l2 y% a
# u5 M1 K- N5 F0 g4 J. `5 c" `0 pHopefully, the doctors will report on a larger study and long-term to see if the
9 r3 Y6 w' j( ?/ s1 @response off Sprycel is sustained." p! d+ r8 \) I5 H6 z4 `* `
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Best Wishes,
4 S) m1 N9 o, l* ?Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
2 p- C8 d( h, T3 zDurable complete molecular remission of chronic myeloid leukemia following
K/ @- _! B) Q0 _: ^# _% Y+ Hdasatinib cessation, despite adverse disease features.
; f- K9 T0 t! a3 O$ h) W7 L- m, mRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
. X8 Q6 J4 @8 c4 ~Source
# E& E0 l( Z3 OAdelaide, Australia;
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Abstract
# w1 W) m0 E3 |3 O0 K- e4 {Patients with chronic myeloid leukemia, treated with imatinib, who have a
. P4 ]! E! s& S% E5 `% ^( R) [1 gdurable complete molecular response might remain in CMR after stopping
8 s9 W2 f) F! Y r# v) Vtreatment. Previous reports of patients stopping treatment in complete molecular/ G' w5 g% `+ X+ Y+ k8 e9 J
response have included only patients with a good response to imatinib. We0 F. ]/ G+ h" D
describe three patients with stable complete molecular response on dasatinib- c8 v1 d, c0 a+ ^) S3 J
treatment following imatinib failure. Two of the three patients remain in, v) v. l* ]" a; R% Q, }1 T
complete molecular response more than 12 months after stopping dasatinib. In# b. l& o1 _+ T B: K! e: w
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
7 ~# a5 X5 v% F, k5 vshow that the leukemic clone remains detectable, as we have previously shown in
7 K, t* g5 f1 q# Cimatinib-treated patients. Dasatinib-associated immunological phenomena, such as9 c8 N, Y5 m% O2 s
the emergence of clonal T cell populations, were observed both in one patient( q# G' }; v3 N9 M' I
who relapsed and in one patient in remission. Our results suggest that the
. w5 {& F' b2 V# jcharacteristics of complete molecular response on dasatinib treatment may be
. V, Z) ^4 j asimilar to that achieved with imatinib, at least in patients with adverse
$ T9 Y3 T' J, R' ~1 k8 vdisease features.2 y0 Q% s9 @8 p. x7 i2 h
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