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。
% C$ t" A  X) A' h- h    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。

作者：来自澳大利亚
2 `' A2 l- \, i0 U4 |来源：Haematologica. 2011.8.9.
Dear Group,

Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
& \. E3 N) \% j+ r3 _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
' J$ Q+ z4 i# F7 o' s2 Hremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
does spike up the immune system so I hope more reports come out on this issue.

( j6 k% y! v& L9 H3 q  g& M# AThe remarkable news about Sprycel cessation is that all 3 patients had failed
4 Y0 G6 F* c, f& w( U' I. fGleevec 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
# y. l1 E4 A  M. a5 }6 gwho have done well on Gleevec.

Hopefully, the doctors will report on a larger study and long-term to see if the
/ e9 t; A: }1 f: t, x# O: hresponse off Sprycel is sustained.

Best Wishes,
Anjana
: [; w  _0 U" V7 \* d' j


Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
  B5 r2 Q, k; K& K5 Q' f" Cdasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
  \( _( P' b. A# z/ u+ p% YSource
Adelaide, Australia;
5 F0 ~- Y% q* N# ~  C
Abstract
5 I. X6 F- ^* q: G2 ZPatients 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
! j& {2 ]# F9 y* Aresponse have included only patients with a good response to imatinib. We
, ~: w  q5 m) F- h! R) Ldescribe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
2 C2 @, n2 W% Kcomplete molecular response more than 12 months after stopping dasatinib. In
( ^/ ]" r; c% H: A0 g3 o8 Vthese 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
# T  T4 U7 p% N7 T  Cthe emergence of clonal T cell populations, were observed both in one patient
0 ]; b6 B8 k2 c3 d. m: a( U( Xwho relapsed and in one patient in remission. Our results suggest that the
* N+ |  v4 ?7 F0 E2 |( o) Y3 M- Mcharacteristics of complete molecular response on dasatinib treatment may be
7 }; L1 b$ x& w) c4 Isimilar to that achieved with imatinib, at least in patients with adverse
& k! S) S8 i4 p# b$ A7 W1 a% `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。
. Y' O5 ?0 A) ~$ |: ]/ p    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。
+ o) l4 _: U% |) S* K/ y6 F8 m6 V/ D    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。

( Z8 X( T7 r( \作者：来自法国STIM试验
' _( |  @3 W2 m+ _) d3 D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