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。
    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
% M& N6 C( ?2 U) i0 Q0 B& s9 v来源：Haematologica. 2011.8.9.
Dear Group,
" U7 L$ D# h9 p; N. V1 o, o
: _" |0 c/ ]4 Q* p0 @Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
- S$ S5 s3 M6 \4 Ktherapies. Here is a report from Australia on 3 patients who went off Sprycel
* B9 R6 i5 k% u; s2 Q, b8 Zafter 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.

- n- m& X! N% R& w2 }5 DThe remarkable news about Sprycel cessation is that all 3 patients had failed
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
: B0 O  T1 K. odifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
' n% W% i2 V+ g8 y
Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

Best Wishes,
Anjana
( _1 l2 g& Y5 N  Q  M. F" z! p

) O7 ]4 `- r8 M$ y& y
( O# p1 J# K: T4 [* LHaematologica. 2011 Aug 9. [Epub ahead of print]
( I$ {6 |, h/ P8 T. I5 H0 r, GDurable complete molecular remission of chronic myeloid leukemia following
/ \. O$ g- q3 e* |9 s( ?dasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
Adelaide, Australia;

Abstract
0 ?' I% X% V2 t3 S8 ~$ V0 r7 BPatients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
4 |8 X  S3 Z4 l% v8 E4 `" f2 c6 |treatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
6 L# h% I" A* `7 A1 zdescribe three patients with stable complete molecular response on dasatinib
. i- ^2 a) L) e  k5 m- m  ftreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
these 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
+ a3 t& c0 f# v) E9 ^imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
3 i; t! z6 f5 {$ b$ jthe 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
0 C3 N( i4 ~& V$ i1 g2 d$ `characteristics of complete molecular response on dasatinib treatment may be
; ^" ?4 U" \  m( ~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。
6 d% b" m: L! D  L' y& F- g: [8 \! e    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。
    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。
5 @' v9 `; E) S- a3 i5 `8 k
. c# T' V" y5 X2 `9 c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