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。
6 p3 _* s0 v* Q. M 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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8 K6 b( |1 O. Q作者:来自澳大利亚
( Z& K6 e$ w# S: t; O来源:Haematologica. 2011.8.9.
9 @( T* v p- x$ L! EDear Group,6 m; D5 ?& W6 W' k8 E) x
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML9 ^% _4 d6 D" b3 S o1 p
therapies. Here is a report from Australia on 3 patients who went off Sprycel
1 S& l l3 l2 E+ m q+ zafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients: r8 A( }) m5 z* [3 C, o
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
3 J n8 D0 e! J/ M% ]9 odoes 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 failed
' Q- G( h5 ?5 MGleevec and Sprycel was their second TKI so they had resistant disease. This is2 x7 ]4 K& [0 I
different from the stopping Gleevec trial in France which only targets patients# o* G: d ^& H* f* ?
who have done well on Gleevec.
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" J6 \7 ?' _" Z5 l, P; @Hopefully, the doctors will report on a larger study and long-term to see if the' Y F* W) Y5 |; u) T7 a
response off Sprycel is sustained.7 H& ~) v' S! y( e0 X2 |8 z
1 _- \% P# }1 [Best Wishes,
1 ]5 z% z+ H4 x* [+ n. O2 SAnjana3 H" c2 o4 b- l' Y& k T
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# y' O. k5 F% gHaematologica. 2011 Aug 9. [Epub ahead of print]
" ~/ B2 q" q& D5 G- q) S4 t5 R7 c: WDurable complete molecular remission of chronic myeloid leukemia following) K0 o; M- D2 V0 A9 W3 @
dasatinib cessation, despite adverse disease features.% |/ n8 U+ L4 t- E
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
1 W) r9 s' o; F- H2 }$ }! ySource
8 K( d7 U2 O6 L( vAdelaide, Australia;
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Abstract$ ~0 X7 s+ K5 D4 X1 N1 N
Patients with chronic myeloid leukemia, treated with imatinib, who have a
0 w4 h; j4 R7 J) f5 w" ?# g/ rdurable complete molecular response might remain in CMR after stopping
$ w1 i# Q, q: N* i5 _& otreatment. Previous reports of patients stopping treatment in complete molecular! Z& L0 q" h. v7 f
response have included only patients with a good response to imatinib. We
& Y1 Q! h9 [3 U! i! H. Wdescribe three patients with stable complete molecular response on dasatinib
1 A6 s9 w/ C9 q, s& u% e7 \treatment following imatinib failure. Two of the three patients remain in+ ~; @* a$ L, t$ ^$ P
complete molecular response more than 12 months after stopping dasatinib. In% u2 b+ Z$ o/ G9 D
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to" A2 t# A: _/ z0 B
show that the leukemic clone remains detectable, as we have previously shown in% d3 ~6 I& [4 \" r' ^1 q
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
% g3 F) ~6 g- ~; U% i, I8 Xthe emergence of clonal T cell populations, were observed both in one patient; O- E- C" V% \
who relapsed and in one patient in remission. Our results suggest that the* g) n6 b( K' x' y: G
characteristics of complete molecular response on dasatinib treatment may be
. N* j" F* D: X8 w1 n: lsimilar to that achieved with imatinib, at least in patients with adverse
3 L% G6 M6 Z4 K! Jdisease features.
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