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。
; F; V5 @+ _. J* x( J1 ?9 D& ^0 f    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
3 B% U% ], g: ~" s6 ]# U% a# e; {来源：Haematologica. 2011.8.9.
Dear Group,

$ b( \$ m5 s- D9 P" t) QSome 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
' }1 m  a5 o' X; I# `, q# Pafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
! e& k  q2 }5 l- f' K$ `remain 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.

$ s5 K1 }# c2 S% [, N$ MThe remarkable news about Sprycel cessation is that all 3 patients had failed
' C% q& _3 d+ n% h* ?3 y, jGleevec and Sprycel was their second TKI so they had resistant disease. This is
  U  i8 K6 j. Z5 O8 V/ [6 I0 x( jdifferent from the stopping Gleevec trial in France which only targets patients
' e- o( C8 a& O6 u/ Rwho have done well on Gleevec.
& g# r6 ?/ I: Y' }9 y
Hopefully, the doctors will report on a larger study and long-term to see if the
, |  n  ]) T+ X; N. |. H* ?response off Sprycel is sustained.
; t+ x$ ?$ Z; z& h7 O, Q& P
Best Wishes,
Anjana

" f0 l, ~; Y! q  W2 ]2 a
7 ?! Y/ I( L7 Z1 K. [0 ]
3 I" z( Q* {6 `) c- QHaematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
8 ]3 M/ G% D- ^# ~& e; zdasatinib cessation, despite adverse disease features.
# ]" v# r- R2 ?Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
Adelaide, Australia;
7 k0 y! R- a1 |* F0 `- T
Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
/ }9 `) G  Q6 C. w2 A9 o; Ftreatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
8 C) V" A3 i* Y9 Bdescribe three patients with stable complete molecular response on dasatinib
5 W( v  I# m5 {6 ftreatment following imatinib failure. Two of the three patients remain in
% @( l3 V; ~8 I5 X- bcomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
6 O: g6 v: q0 v" Mshow that the leukemic clone remains detectable, as we have previously shown in
- }) \8 U% Y* z: `, limatinib-treated patients. Dasatinib-associated immunological phenomena, such as
. e9 o& E5 [2 `" Dthe emergence of clonal T cell populations, were observed both in one patient
. @& V. B" s4 Q/ A2 R, fwho relapsed and in one patient in remission. Our results suggest that the
characteristics of complete molecular response on dasatinib treatment may be
; Z0 E, D; G- z+ gsimilar to that achieved with imatinib, at least in patients with adverse
, [/ z, c  Z0 A: |1 b0 Q: cdisease 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。

) [& \. e3 W9 M7 R作者：来自法国STIM试验
/ H4 c6 g( O$ u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