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。
3 s* |% V8 h% r* i 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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2 G) L% D2 v+ c作者:来自澳大利亚* Q1 _+ d' Y/ ^9 l! P
来源:Haematologica. 2011.8.9.
5 X7 e- G. q9 E9 b* u3 `Dear Group,
3 ~- Q# ~* R5 J( W" X" `
+ {( F. F4 H: [5 xSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML% l$ E. _4 `5 k' s' e1 H
therapies. Here is a report from Australia on 3 patients who went off Sprycel: A5 @: h& U2 S6 M T+ l; \
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients* m `' ] x7 A8 V
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
& n- [8 w* B1 T5 ?* m2 f$ g& Udoes spike up the immune system so I hope more reports come out on this issue.
. R, n5 ^8 T5 w( \. C8 z& t2 X' l- b$ R: ^1 J0 w d* u% q6 {9 q
The remarkable news about Sprycel cessation is that all 3 patients had failed2 ?' p( a* e' U7 O
Gleevec and Sprycel was their second TKI so they had resistant disease. This is& K$ R7 ]1 u/ L" ?9 j5 i
different from the stopping Gleevec trial in France which only targets patients
8 `4 K5 c( D$ S4 _+ B* Swho have done well on Gleevec., y$ s" e1 i, C$ U& [, z5 D% }
1 w2 H) d6 l7 Y4 p
Hopefully, the doctors will report on a larger study and long-term to see if the
( a) x" S1 A# iresponse off Sprycel is sustained.
2 ^, u( s- X! e0 x
- g+ y) o* i9 B) |# C" C6 ^! xBest Wishes,
% B( z8 C; s2 H0 U3 c+ l0 KAnjana! H; f4 c$ ~2 i9 w" ^, o
4 a# Q7 i$ f1 ~7 E3 E# {
K8 O/ Z% w0 b& Q" v5 @5 U1 q$ m
* R9 {7 z+ ?' v9 H" m) o7 HHaematologica. 2011 Aug 9. [Epub ahead of print]
' o9 _7 e5 a) {/ O8 Z; nDurable complete molecular remission of chronic myeloid leukemia following
c$ Q) Y8 h& odasatinib cessation, despite adverse disease features.
( @) V& m4 K" j* ]- S' x9 C3 ZRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.% q* Y+ Z4 L! C% H8 e. u' R
Source
. {5 D+ i4 G8 ?, B% k/ q( yAdelaide, Australia;- ?; v. E! b5 }" A! M( w) J
; }" F" }% i, c' MAbstract$ R) k5 t7 H' b6 |8 @
Patients with chronic myeloid leukemia, treated with imatinib, who have a$ a6 j; @) C% z0 _ c }( c
durable complete molecular response might remain in CMR after stopping& e6 X6 D0 j9 _: \0 N# e
treatment. Previous reports of patients stopping treatment in complete molecular
3 u, s% q5 s8 Z! e3 a8 Lresponse have included only patients with a good response to imatinib. We
! ~. q; e, D" ~! U5 q- `$ @# v9 Gdescribe three patients with stable complete molecular response on dasatinib
_. s! ]4 r" Y$ s& r4 U! e7 `6 o: {( Ytreatment following imatinib failure. Two of the three patients remain in4 L' f s4 S' `& i, e; c1 p& P
complete molecular response more than 12 months after stopping dasatinib. In7 t8 R: c* F: R- {
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to+ _( D* n7 A, x. t ~% \1 S. E
show that the leukemic clone remains detectable, as we have previously shown in) O/ {8 s+ p% v$ y7 D" V% k
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
5 C" F% i5 T4 ythe emergence of clonal T cell populations, were observed both in one patient
5 O7 c) b* w; O$ U$ I, L* Gwho relapsed and in one patient in remission. Our results suggest that the
9 i+ H! B, r% }8 b; t0 Ocharacteristics of complete molecular response on dasatinib treatment may be
4 L( K5 W6 q" S; w& ssimilar to that achieved with imatinib, at least in patients with adverse
# ]5 i7 b9 i! V( b- D( x) [disease features.+ I/ m9 ~3 J1 w( B! @
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