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。

  D, Y# u. u4 d) T4 X  [作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,
5 `; I% G9 O: G
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
/ f. M) i9 m2 R% I$ h* F( [after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
6 [0 {) _" M# p6 L4 m4 cremain 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.

2 n# k7 l0 G0 l6 f  d; @& HThe 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
different from the stopping Gleevec trial in France which only targets patients
! h9 ]! Z1 U, L- swho have done well on Gleevec.
& P2 T; C  A1 w! p4 a$ ~8 `) J% g
Hopefully, the doctors will report on a larger study and long-term to see if the
2 E( ?" B% \& H$ L+ Iresponse off Sprycel is sustained.
  c: c7 m1 i( s3 t/ P# _- @" H
Best Wishes,
Anjana

& A0 ?; h1 B3 L, M3 D1 U

3 P/ g* T' f4 v3 N4 OHaematologica. 2011 Aug 9. [Epub ahead of print]
7 V- D( j& |9 b- LDurable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
/ ]/ n% K7 `/ @! P% q( o) sRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
Adelaide, Australia;
/ h' ?' Z) Q# o8 X# `& s! A# r
- C7 W! `! O$ X# l( ^5 |Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
- U) x7 V' ?) ^! w3 W5 edurable 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
3 a2 t5 l) k& a+ {: Ndescribe three patients with stable complete molecular response on dasatinib
' ?' |$ u% p# ?/ y+ S* mtreatment 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
8 T: M3 g5 b3 p5 ^! |show that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
" A' n9 l/ D! s# t* }the emergence of clonal T cell populations, were observed both in one patient
  o- l% `. Q- mwho relapsed and in one patient in remission. Our results suggest that the
  [7 L4 `  E# T7 Xcharacteristics of complete molecular response on dasatinib treatment may be
/ t/ b7 P5 @2 csimilar to that achieved with imatinib, at least in patients with adverse
& m4 j' s8 n2 p2 @( V: e6 e9 ddisease features.
$ M: ?" Z6 s6 {, z- G" |

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。

- j1 B+ s$ s8 F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