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。
! V0 d+ {$ W& V1 I) R# L- m. K& P    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
来源：Haematologica. 2011.8.9.
Dear Group,
4 G. _" V/ Q' Z$ o( O) |0 V
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
" ?, N) n! W7 e% Gafter 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
- V2 N5 \* |4 c! ddoes spike up the immune system so I hope more reports come out on this issue.

& ~# L* s' e, Z0 i; L' ^: JThe remarkable news about Sprycel cessation is that all 3 patients had failed
) ]: Y, S0 L3 C  ^# D/ }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
* f( ^6 @2 ^8 H9 Nwho have done well on Gleevec.
; K' U7 K% J8 g+ B; P3 }2 W/ x. S
) N7 K# e) k- Z" D2 I! c* yHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

Best Wishes,
Anjana



Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
! X* x$ K2 w$ qSource
' C( q; ]% x/ EAdelaide, Australia;

Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
$ s( R3 n$ T* B  e0 wdurable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
3 h: M) h+ }+ {: e9 U  lresponse have included only patients with a good response to imatinib. We
8 O& h/ b/ o2 U" ], y' ?describe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
1 y% u% J$ R2 j1 m* l* s. ncomplete molecular response more than 12 months after stopping dasatinib. In
3 p, u" C/ m/ a1 t- o4 a9 [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
6 i$ _2 D3 I( A* K- ]* E; i0 b$ Qimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
0 m, w" l7 ?& Ewho relapsed and in one patient in remission. Our results suggest that the
- v& l0 L, k/ M/ a  j! L& xcharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
- w# Y6 M2 J! K: q  _disease features.
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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。
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  W7 }5 u8 q% ]+ K4 G9 h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