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。
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
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
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
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
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
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.

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


  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.
Source
. {5 D+ i4 G8 ?, B% k/ q( yAdelaide, Australia;

; }" F" }% i, c' MAbstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
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 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
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.

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。
9 D2 o. @2 d. k/ q2 B# a    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。
% B/ D& g5 I& E6 H, {: L    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