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。
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作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,
3 q" ]$ Q7 |" ^- z* V. k0 x
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
! L* {# V! _. j; `- Utherapies. Here is a report from Australia on 3 patients who went off Sprycel
: z- ?' o9 l0 U& |2 i$ Oafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
! P# I  H$ v5 w* T: s/ ]remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
. q! e' G% R# {# y- Q' v- l" ndoes spike up the immune system so I hope more reports come out on this issue.

The remarkable news about Sprycel cessation is that all 3 patients had failed
4 |* z; \( G( k- ^1 @% i9 ]5 pGleevec and Sprycel was their second TKI so they had resistant disease. This is
/ p! c- ~; g, N1 a) R# ]different from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
, c# U5 r6 ^- z; u+ u- O
" m6 c, j, W3 `% ^1 s/ f" IHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

+ p% j& x0 H4 W5 _* uBest Wishes,
4 P- B/ h  @3 A) r5 Q7 QAnjana


  A  y( m# ], x
Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
! F: b4 A/ K; L' Y3 i; c# RRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
- V+ V' ^  b( V+ O' ZSource
Adelaide, Australia;
4 W* A: y2 S9 z/ S! i! r; y# c6 J
Abstract
9 K, N1 `- d4 ~, X+ yPatients with chronic myeloid leukemia, treated with imatinib, who have a
/ a% X1 {3 \# P" Zdurable 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
% s8 q1 n9 A: r7 v9 U  z9 mdescribe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
+ i1 ]# |4 K- l: z' U* u' icomplete molecular response more than 12 months after stopping dasatinib. In
/ Y6 S3 R6 Y/ X7 P5 Uthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
1 d. p$ ]8 u8 r8 T/ ?show that the leukemic clone remains detectable, as we have previously shown in
9 h" T, q' W/ \: N4 X* K6 u. z/ a* g' Oimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
  ]# i) q4 X) p1 ^$ \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
* z  o0 d4 _' w) Zcharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
5 M! W* U! ~5 B. ?! I( _) Pdisease features.
" J8 h+ u( c# @7 p- p" R2 H( `# I, f

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
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