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。
0 A, T; W( ]8 u5 } 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: {+ C1 v0 i1 Y8 Z
来源：Haematologica. 2011.8.9.
6 f L! r, Z* _: U4 @Dear Group,8 }2 ]1 O& {4 y% {0 k6 e8 P" R
8 {, T1 g3 E$ b
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
& Z2 U% z5 n6 b1 |: J+ rtherapies. Here is a report from Australia on 3 patients who went off Sprycel
1 N6 D% O9 h R- Zafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
. y0 ~6 R; U+ C# H) fremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel- q1 y# Y8 x2 V/ ~
does spike up the immune system so I hope more reports come out on this issue.( L: M( g" \7 w0 P
" j3 n9 M' w7 \ Q
The remarkable news about Sprycel cessation is that all 3 patients had failed4 n8 l8 {5 Y0 n* _# `- u- r# E. G9 m
Gleevec and Sprycel was their second TKI so they had resistant disease. This is5 F0 }7 t6 ~$ ]+ n2 E6 b( Z
different from the stopping Gleevec trial in France which only targets patients
6 B& I$ Y* g8 o- mwho have done well on Gleevec.( F! w& ?+ T% l/ Z
8 w* A# c0 r1 M* |
Hopefully, the doctors will report on a larger study and long-term to see if the
; i. I! b; ~1 A, O0 v# fresponse off Sprycel is sustained.
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* s+ W7 O6 d# L9 {: F5 Q/ V0 m9 QBest Wishes,- T# A# B4 k4 c2 ]* a
Anjana) C6 y: z7 z+ [5 Y. @
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Haematologica. 2011 Aug 9. [Epub ahead of print]
/ i$ b9 ]6 X. y$ K8 \Durable complete molecular remission of chronic myeloid leukemia following3 v7 C* c! V! v Y3 a, ]' P
dasatinib cessation, despite adverse disease features.
! k$ E; |1 x$ Y, `( ]& \# QRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP., ^$ d3 i) V6 [! ?4 F
Source
! r3 Z! { _9 W5 U5 j f0 KAdelaide, Australia;! z; Z d8 b! e8 d5 s( s/ z; @
L! f8 F6 N' K* D% A6 z }Abstract
; a! V9 i& \2 D! Z s. t* N; a _Patients with chronic myeloid leukemia, treated with imatinib, who have a
/ C& z7 H. Q* }' u3 o' Vdurable complete molecular response might remain in CMR after stopping
& N/ x5 J! \4 S& ]' J. d+ otreatment. Previous reports of patients stopping treatment in complete molecular2 a8 R7 r5 J2 s7 Y0 L6 A# x. P& Q
response have included only patients with a good response to imatinib. We( A; F& i/ T9 F H$ s" _2 ~0 i
describe three patients with stable complete molecular response on dasatinib3 T- A" |2 \- S& a- d# w; T- f
treatment following imatinib failure. Two of the three patients remain in
# s: H; _0 s. g* d9 `6 [. Ncomplete molecular response more than 12 months after stopping dasatinib. In
: R6 B. E1 e/ n2 tthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
5 P. v; Q8 o% d. }! [) [ V* Vshow that the leukemic clone remains detectable, as we have previously shown in* ?& }8 x+ e1 k# D
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as% g7 _/ N G# [- M
the emergence of clonal T cell populations, were observed both in one patient
( N# o, S2 D2 W4 R6 ~2 t- R. Kwho relapsed and in one patient in remission. Our results suggest that the
: B, C I2 V' ?characteristics of complete molecular response on dasatinib treatment may be
1 v- U) s, s. K' u4 I( xsimilar to that achieved with imatinib, at least in patients with adverse" M9 m' ~1 l( t# p0 b- ^
disease features.6 e9 Z+ A) W" m0 \# l
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