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。
    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。

; q2 K+ l7 Q# ]% W4 m8 s1 [9 ?作者：来自澳大利亚
8 _% E' ?* q$ x) \. ?; j5 }8 Q+ G5 G来源：Haematologica. 2011.8.9.
Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. Here is a report from Australia on 3 patients who went off Sprycel
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
* ^7 F! u( ^! r1 ]- Z$ ?( W: i$ premain 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.
# m4 b% M0 l3 }0 d% R
. [! t7 ]/ L. z5 K" \4 @# A! R9 \The remarkable news about Sprycel cessation is that all 3 patients had failed
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
8 B: p  T/ {4 a/ S/ c4 J6 g# idifferent from the stopping Gleevec trial in France which only targets patients
& ~0 f8 t, a& e" k8 [4 iwho have done well on Gleevec.

; A* x4 k' c6 F6 u9 J' q0 EHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
/ L! }  v- I1 W% C& q
Best Wishes,
6 z' r# P& [0 H* {' _Anjana

5 @; g' d4 m$ P5 l7 A8 v
. m8 _2 U( J' @( H8 L& e
7 d9 Y' i: ?* Q9 A, M) fHaematologica. 2011 Aug 9. [Epub ahead of print]
% {- q4 h9 H' _" \Durable complete molecular remission of chronic myeloid leukemia following
& A2 s3 }- i, `) j* N- Zdasatinib cessation, despite adverse disease features.
* a. a0 }- k. ?3 ~* Z2 j8 E, mRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
) z, G1 T8 d0 l6 ~Source
Adelaide, Australia;
; T+ C6 y& u$ v
Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
' Z! i1 h" \4 y' \' fdurable 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
- G+ ^, z' e2 E% q& d$ _& t4 \describe three patients with stable complete molecular response on dasatinib
' ~/ c+ t  D3 D! z" c% ?$ X, Btreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
show that the leukemic clone remains detectable, as we have previously shown in
' `& P- F4 k* |& eimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the 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
$ ~6 q2 p1 o+ U: Kcharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
. p1 G3 Q; j: J( ]5 u/ ~- ydisease features.
, W4 V7 C) |2 l3 X$ e+ ?

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。
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8 R+ v; H% b/ G& t( _2 U0 f/ s5 Q7 [作者：来自法国STIM试验
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