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8782 15 老马 发表于 2013-5-14 07:55:26 |
老马  博士一年级 发表于 2013-5-14 08:04:04 | 显示全部楼层 来自: 浙江温州
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.
% d* O; U4 ], ^! b* s3 m4 d' }) n* x# D: f, k* M
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.
( _& _# Q! Q8 L4 A1 W/ I: s2 T% v
! 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

/ I  a" G7 y  ], p3 r# H4 v: [
  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.
$ k0 T0 b. a3 d% b, }Source# n" d/ p0 Q2 Y; y5 z
Adelaide, Australia;
( a" ?7 e  p* u4 u5 V4 w! u. A4 _$ P. y2 O. s
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.
" w, U5 N5 a- T  a/ I
个人公众号:treeofhope

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老马  博士一年级 发表于 2013-5-14 08:04:25 | 显示全部楼层 来自: 浙江温州
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。
# l2 x3 f8 v: \7 A    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。% A2 Q: D! [) r. \$ N
    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。: X5 F' Z* F! t+ i! u7 N1 s' K
6 M8 C7 ~! |" u( [2 m5 d
作者:来自法国STIM试验. G7 D' k6 C0 \- e
来源:EHA 2011.6.会议摘要
个人公众号:treeofhope

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gjzlovemama  初中一年级 发表于 2013-5-14 23:45:09 | 显示全部楼层 来自: 山东滨州
很不错的文章,看来马老师家有考虑停药的想法了啊!祝福!

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jack_7777  禁止访问 发表于 2014-11-22 19:47:19 | 显示全部楼层 来自: 广东广州
提示: 作者被禁止或删除 内容自动屏蔽
签名被屏蔽
sdlclqm  大学一年级 发表于 2015-9-29 19:03:13 | 显示全部楼层 来自: 山东聊城
期盼易或特也能停药,但现在觉得是一个梦想!
monekyll  大学二年级 发表于 2015-10-2 12:44:50 | 显示全部楼层 来自: 广东
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

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