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。$ H; y9 u! U6 G, n. z( U0 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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作者：来自澳大利亚1 r" L% J: t' x/ Q9 [3 F
来源：Haematologica. 2011.8.9.: ?5 H4 M! M+ c) Z! h# d
Dear Group, V' f3 `# {7 U0 \/ C4 W3 |0 E
7 G3 j5 Y- S5 W& |1 V8 fSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML! l* z# _* b, W3 W, C# _
therapies. Here is a report from Australia on 3 patients who went off Sprycel3 u0 ?2 O, F; t% f
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
2 o7 N8 G; K- t5 y' g) _remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
4 V, {! [7 w! E: Bdoes spike up the immune system so I hope more reports come out on this issue.
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1 C) }: r2 ^6 XThe remarkable news about Sprycel cessation is that all 3 patients had failed
/ U- f& w4 {7 @+ ^' _Gleevec and Sprycel was their second TKI so they had resistant disease. This is% G$ C# D5 f) `+ a6 F1 L2 q
different from the stopping Gleevec trial in France which only targets patients9 o# ` Z/ f; \8 g: E5 m
who have done well on Gleevec.1 O! I3 r$ Y# t) F1 w
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Hopefully, the doctors will report on a larger study and long-term to see if the
3 L# f Y" d" z* O) Nresponse off Sprycel is sustained." F/ M' K" i7 b9 H' x
, g* {: t4 N) j1 E- ~! d2 p6 MBest Wishes,3 Q! F* ~9 E' q7 O0 c) h
Anjana6 B# A [2 o2 J" M) J
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- U# S' P, }: q: s# VHaematologica. 2011 Aug 9. [Epub ahead of print]
9 M6 d8 h, h6 Q- U% U, S# u! H sDurable complete molecular remission of chronic myeloid leukemia following
( D+ j! D3 h0 Z1 ~+ {. B6 Adasatinib cessation, despite adverse disease features.
# h# {; ~4 I4 T" u1 eRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
6 T: [! E! [1 v2 m5 Z+ e3 o0 tSource' ^( F6 l' P2 n( w& }& g
Adelaide, Australia;
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Abstract
4 j9 }$ e0 W& EPatients with chronic myeloid leukemia, treated with imatinib, who have a! a5 x% e9 U% w: ?# l; m
durable complete molecular response might remain in CMR after stopping' r2 w' R7 K9 E/ x/ ] ~
treatment. Previous reports of patients stopping treatment in complete molecular
$ `% q) [5 W6 W' C+ i7 zresponse have included only patients with a good response to imatinib. We2 ~& m$ H$ [% [% c
describe three patients with stable complete molecular response on dasatinib7 R) w. e8 ^- u) f/ v
treatment following imatinib failure. Two of the three patients remain in6 _2 |3 ^3 E$ t) t5 C
complete molecular response more than 12 months after stopping dasatinib. In
! S9 p! g7 L& x; J% G- v1 Lthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
+ W) i! y" G. e9 eshow that the leukemic clone remains detectable, as we have previously shown in
0 A! H% h7 T3 o# _imatinib-treated patients. Dasatinib-associated immunological phenomena, such as5 W9 d4 T* ? o4 U
the emergence of clonal T cell populations, were observed both in one patient
7 k% o, L- D4 Z- K4 Q y* lwho relapsed and in one patient in remission. Our results suggest that the6 b/ a* q5 ? K7 R! W: Z
characteristics of complete molecular response on dasatinib treatment may be/ w3 X- f4 b# t2 b* J& c6 G N
similar to that achieved with imatinib, at least in patients with adverse
1 r6 s9 ?# F: z5 }; _) [disease features.
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