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。
0 h4 I+ g9 p, R' Y    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
4 b$ {4 a/ w4 `' S" L0 B2 J' Z来源：Haematologica. 2011.8.9.
Dear Group,
9 G$ i0 {5 ?2 n; }' H, ]5 \
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
/ J4 Z, ^% |# X/ htherapies. Here is a report from Australia on 3 patients who went off Sprycel
8 S5 H2 h( N1 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
does spike up the immune system so I hope more reports come out on this issue.
3 M) n! Z5 T, d, Q0 _, e
The remarkable news about Sprycel cessation is that all 3 patients had failed
3 F0 i0 N4 T: q- h" J/ |0 p8 x/ UGleevec 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% T3 L# h/ t5 I% @8 ~! }( kwho have done well on Gleevec.
5 k: `0 Y9 H% r
Hopefully, the doctors will report on a larger study and long-term to see if the
1 a( _9 w# c+ S- H+ Yresponse off Sprycel is sustained.

: M7 ^4 ^+ o/ w; M6 E$ vBest Wishes,
- U, w0 H. ]0 p9 E+ c  y; T1 hAnjana



Haematologica. 2011 Aug 9. [Epub ahead of print]
* D! x, H+ |8 K+ k, p) L/ }Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
5 f( R/ z$ W+ ]* FRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
' V7 A1 ]8 \2 e% d" V* q+ TAdelaide, Australia;

Abstract
$ |; O% R6 [8 d. I8 ~Patients with chronic myeloid leukemia, treated with imatinib, who have a
5 b- s: u" q& ^8 K& @, Ydurable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
% A* J% V, j8 C6 Y( gresponse have included only patients with a good response to imatinib. We
6 k% E# d% L) x2 ydescribe three patients with stable complete molecular response on dasatinib
) g* `+ Z: k& n' A, a& y  dtreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
* J1 E+ N8 |2 N  s8 pthese 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 T  W2 a/ B' I5 p' a, R7 wimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
4 [; a1 h+ x' A6 B% u/ ?the emergence of clonal T cell populations, were observed both in one patient
who relapsed and in one patient in remission. Our results suggest that the
4 V4 J. p7 _2 @# \  W/ g( s( Rcharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
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。
    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。
) z7 t# J1 u% R6 J    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。

- V- r5 `6 }, \/ K3 ~  z& 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