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。& c8 v; @ I2 g4 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。* @" | l9 S% S& j: h$ N
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作者：来自澳大利亚
5 |$ s" S. S2 j+ q来源：Haematologica. 2011.8.9.. ~; i' G: O3 I) H- m
Dear Group,
. A, L, G/ N' U8 N: ^
{5 e/ A2 M! A: `7 i ?Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
& S- ~0 F" I& utherapies. Here is a report from Australia on 3 patients who went off Sprycel$ @9 Y" t: ~; ], Z3 s- \1 U. o
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
( A9 v3 U$ A/ W8 H% U" g$ l" wremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel+ J J( {$ y, Y/ C
does spike up the immune system so I hope more reports come out on this issue.
1 ` I5 Z8 p5 d( E# I$ \* E0 c: _+ X1 u
The remarkable news about Sprycel cessation is that all 3 patients had failed& b9 A, t) V a. k* t# \. u5 K* I
Gleevec and Sprycel was their second TKI so they had resistant disease. This is8 P$ D' Z u3 t/ s- w
different from the stopping Gleevec trial in France which only targets patients
' C# E* q/ J) S6 y7 F+ \who have done well on Gleevec.: U. ]' @" O, s. z, Z
: X. k% p. [" w) T( ]Hopefully, the doctors will report on a larger study and long-term to see if the l6 c* v) N. E- U% L8 `
response off Sprycel is sustained.
7 G6 {0 [+ h( ?- s
- l3 W: @, m6 d W% H( KBest Wishes,
3 Z- c. \* ]: c2 e8 \1 A. OAnjana4 {0 @3 q* \5 Q" K* p
9 w; w. J% p* ?" W) R R" y3 A1 Y
0 ^/ d" N' j: D4 f. Q9 v, R
1 ^- z/ L: a7 S0 q. |Haematologica. 2011 Aug 9. [Epub ahead of print]
1 Y" c" @5 L9 n1 A2 V5 o2 `) K2 JDurable complete molecular remission of chronic myeloid leukemia following
: [( P1 F. v; K7 zdasatinib cessation, despite adverse disease features.
6 X) B( ^+ k: ~+ ^% QRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.0 X- }+ D' {0 m9 R1 K6 ~
Source
7 H( c' j# I/ q1 X+ gAdelaide, Australia;
4 i/ @; h8 \. `: f* N+ @! n. ]
* X# m6 T! t' O" C+ s' z/ XAbstract8 |" P, v- J3 i; e5 P- z& T
Patients with chronic myeloid leukemia, treated with imatinib, who have a, J: S, K$ D6 v9 v8 d; r
durable complete molecular response might remain in CMR after stopping
: w S$ ~: F5 Q6 l) U- H0 Ztreatment. Previous reports of patients stopping treatment in complete molecular
( l7 i2 {2 y0 n I Y0 s9 E2 b0 {8 e. y2 vresponse have included only patients with a good response to imatinib. We: n* C6 w6 F6 q: Q8 n+ V- V
describe three patients with stable complete molecular response on dasatinib( V' A5 ]! t! d* j* r) h+ Y
treatment following imatinib failure. Two of the three patients remain in
7 |) b1 D% ]3 P, e7 Mcomplete molecular response more than 12 months after stopping dasatinib. In& N" }6 k8 q* X C
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to/ }5 [; k! W+ K* W
show that the leukemic clone remains detectable, as we have previously shown in
. ^ U+ a+ d' ?+ gimatinib-treated patients. Dasatinib-associated immunological phenomena, such as# c5 `" }) r; ?8 ?; J
the emergence of clonal T cell populations, were observed both in one patient
5 y8 S% \6 G0 W; L; P' D% swho relapsed and in one patient in remission. Our results suggest that the* Y& c) h3 h- T: X/ }; o9 j
characteristics of complete molecular response on dasatinib treatment may be
) v) Q! m% P8 P3 e. F) Z% `similar to that achieved with imatinib, at least in patients with adverse% P) V' H. ~' f7 n$ e# M
disease features.' Q1 D3 g( s0 Q, t6 G1 \
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