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。, q) s( s4 R% P+ G2 Z/ w
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。7 B9 _9 M8 }$ H. [/ x* X6 X
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作者：来自澳大利亚
$ Z( o% L6 z) U Q/ p% _+ O来源：Haematologica. 2011.8.9.
& d: `8 U: R1 R1 \" `+ W0 N! H9 mDear Group,; b% V \5 }3 H6 A' H
; r* T. e- w+ d5 K. [
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
. u, X, M& ]- R& @% h: |/ u- ?therapies. Here is a report from Australia on 3 patients who went off Sprycel
1 ~ i, W8 F0 F1 Wafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
' l: v0 X: J! T3 _remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
' q, ]# M8 y4 ^" h& e6 qdoes spike up the immune system so I hope more reports come out on this issue.
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The remarkable news about Sprycel cessation is that all 3 patients had failed* b7 u, y8 W1 [+ X5 N
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
x+ @$ o# H! [" ^different from the stopping Gleevec trial in France which only targets patients+ a" M' B2 y( a* z+ ?! y
who have done well on Gleevec.; D$ R0 }0 D# m' f" J8 p
8 a# j1 F, i" T! xHopefully, the doctors will report on a larger study and long-term to see if the
. L6 \' M( w7 t5 H0 t* Z( vresponse off Sprycel is sustained.8 q+ A3 q; {) B$ n
6 c) c) M9 S+ X% ~" [+ [Best Wishes,* v# z( [4 R8 s4 w. t3 j: P+ w
Anjana' o2 o' F. }: b1 E) U
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5 p% I7 r$ u h. @) u5 zHaematologica. 2011 Aug 9. [Epub ahead of print]
% X- k! S0 y( F% o% I, U, SDurable complete molecular remission of chronic myeloid leukemia following: h* n/ s. q g* d
dasatinib cessation, despite adverse disease features.
' `0 D: K x. uRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.4 o, R% A* Q$ l+ |2 |
Source% K0 L) c6 V/ I, ~/ c4 u4 Q: p
Adelaide, Australia;
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Abstract
! e; |0 y) z. ]/ }+ KPatients with chronic myeloid leukemia, treated with imatinib, who have a
" J" p/ d% k6 M* e- gdurable complete molecular response might remain in CMR after stopping
% J/ T# j/ K! a1 Q: Z: utreatment. Previous reports of patients stopping treatment in complete molecular
2 p! I$ \- L) yresponse have included only patients with a good response to imatinib. We
5 x; G, r2 c1 o, S# u0 gdescribe three patients with stable complete molecular response on dasatinib1 ~' @+ {( U# h: y) [
treatment following imatinib failure. Two of the three patients remain in. M. |" p* m8 f$ H% h8 J, N
complete molecular response more than 12 months after stopping dasatinib. In
- i/ x+ v: ], t1 Vthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to; f& [. O+ {) j
show that the leukemic clone remains detectable, as we have previously shown in
. D4 c, {6 u$ V& Dimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
! Q7 o9 I0 {/ F. ?) {the emergence of clonal T cell populations, were observed both in one patient7 w9 I- x7 V9 K- W/ @4 E5 W7 h+ O
who relapsed and in one patient in remission. Our results suggest that the5 _# Q1 `3 [ x, _) O
characteristics of complete molecular response on dasatinib treatment may be
. I: \9 T' m- r0 ysimilar to that achieved with imatinib, at least in patients with adverse6 l0 r/ r$ @* p8 c2 x
disease features.3 o# U- g0 R1 E, D3 G8 Q0 w+ j; p) q
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