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。
5 ~" I- l* U9 [5 l0 d& X- F 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。* |0 x$ c. o" [, k! l$ ^
/ D j4 {! D% y7 s6 X' m作者:来自澳大利亚4 z, V% @6 N1 {; p' G
来源:Haematologica. 2011.8.9., X8 C8 V; c& L( G: t& L: j d; d
Dear Group,( g1 z" r& W0 U- K8 L! \" ?
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML' A% A# ]" n' e$ m
therapies. Here is a report from Australia on 3 patients who went off Sprycel+ E9 I. D8 c2 m2 R/ i
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
- O( \- d( t) G# T1 Wremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel- D( h8 c$ p9 c" g- t
does spike up the immune system so I hope more reports come out on this issue.
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The remarkable news about Sprycel cessation is that all 3 patients had failed2 @# g# g( E; ]5 h2 ?9 X: c
Gleevec and Sprycel was their second TKI so they had resistant disease. This is+ U! O2 D& q; n5 p7 l. k
different from the stopping Gleevec trial in France which only targets patients
" j1 C v9 g5 s: p8 e% Y- w1 Wwho have done well on Gleevec.
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! H+ ^7 m Z& Y$ K+ b( U0 MHopefully, the doctors will report on a larger study and long-term to see if the$ u2 i1 G: m( r; B7 p
response off Sprycel is sustained." ~# @, l5 @% {
* h. y7 m: w3 {9 o* ]( N1 \' IBest Wishes,
9 g3 C2 N4 h; ^2 `. I6 e$ XAnjana4 }3 a; G0 w3 }7 s4 { x
# i( \+ x* C; C0 W
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v* v" I6 Z `, Z& D3 CHaematologica. 2011 Aug 9. [Epub ahead of print]
6 T5 P; ]" I/ U9 k, z6 wDurable complete molecular remission of chronic myeloid leukemia following
' R8 V6 s* Z ^dasatinib cessation, despite adverse disease features.2 e) N' i* t. L2 v( t
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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Adelaide, Australia;
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Abstract9 h. d) E }' p; v% P
Patients with chronic myeloid leukemia, treated with imatinib, who have a- m5 O3 f% i" F
durable complete molecular response might remain in CMR after stopping! W8 Q" E+ W" l) z2 F/ Y
treatment. Previous reports of patients stopping treatment in complete molecular
" H( E0 D9 N% ?; q: |1 X2 R1 Q2 oresponse have included only patients with a good response to imatinib. We: C* r. a9 ~( ~0 F
describe three patients with stable complete molecular response on dasatinib
* k; T) h% I3 c$ [+ {treatment following imatinib failure. Two of the three patients remain in _$ u3 L$ U, Y' P7 x
complete molecular response more than 12 months after stopping dasatinib. In
5 K! V+ f! P- o9 U4 y, q) Rthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to% [% }3 @; c) `
show that the leukemic clone remains detectable, as we have previously shown in
* `4 A+ g" z- \$ P; U+ Zimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
' M/ q1 s/ S1 T" ]5 n8 w bthe emergence of clonal T cell populations, were observed both in one patient( Z D8 Z0 L$ ^! y k. D4 E: r/ `
who relapsed and in one patient in remission. Our results suggest that the
- B; V/ z f2 g9 |) fcharacteristics of complete molecular response on dasatinib treatment may be1 D+ ~$ ]' i( t6 l7 H2 f
similar to that achieved with imatinib, at least in patients with adverse+ a F, R1 h/ |, r4 g
disease features.
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