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。
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1 M0 h; x" S. d9 M5 r+ ^作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,

Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
3 Y( t2 Z! A% E5 i( W6 Mtherapies. Here is a report from Australia on 3 patients who went off Sprycel
% r9 _8 A( @. F' w, N6 \- iafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
+ }( G/ }: h9 m. B- K2 Bremain 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.

The 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
# v+ p: W% N2 x/ X' cdifferent from the stopping Gleevec trial in France which only targets patients
# ]0 k2 E/ J, Z* Q: c. Y4 _/ k/ dwho have done well on Gleevec.

. P8 _- r. e5 HHopefully, the doctors will report on a larger study and long-term to see if the
1 Z+ @( }: x4 ]1 Iresponse off Sprycel is sustained.

Best Wishes,
! Q! S: ^; H8 c) M) JAnjana
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2 K4 x/ t: y4 \* E0 y: p1 ]& X! u
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Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
5 y1 N5 U6 e8 E4 N3 R; W- ERoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
) |% y- V( }$ r9 k! o8 C& OSource
Adelaide, Australia;

Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
. O0 v% J: U6 U' o  Q$ u# hdurable complete molecular response might remain in CMR after stopping
0 G0 g+ b6 B( B% D3 U! B1 \treatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
; t( J* E; j0 H& [) }, Sdescribe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
) [0 z6 c4 M& W; Pcomplete 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
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
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
; d/ p6 c5 D/ Z: a. n2 F: F$ @* `; }' v3 J- ncharacteristics of complete molecular response on dasatinib treatment may be
& ~( P: Q1 h3 q/ J" E2 x" s( v! z' o* ysimilar to that achieved with imatinib, at least in patients with adverse
disease features.
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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。
    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。
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作者：来自法国STIM试验
  ]4 Z# {& A( G8 f3 j$ n3 c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