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。
+ B" u% w K# L- \' q3 r 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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作者：来自澳大利亚( }/ }! {" j3 C' l5 b" H3 O
来源：Haematologica. 2011.8.9.
# |6 S- y9 w) S7 d9 K0 zDear Group,
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' h! G( R. Y7 K% n+ ~$ QSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
1 t3 i) E" z, q2 p ntherapies. Here is a report from Australia on 3 patients who went off Sprycel: h9 ?5 _$ a- Z6 ~- y% ^- Y
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
3 f/ G" p# f( O7 Lremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
/ j- y" X+ |$ odoes spike up the immune system so I hope more reports come out on this issue.+ I8 u8 Y# ~6 c
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The remarkable news about Sprycel cessation is that all 3 patients had failed
! s0 q( H; S: b# g+ q( R: p) wGleevec and Sprycel was their second TKI so they had resistant disease. This is
T( p# O8 q t5 r$ idifferent from the stopping Gleevec trial in France which only targets patients
: z6 \) F; E- ?% b& m- A0 H- Y6 A& Ywho have done well on Gleevec.
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1 E. l; d% F- |* w. D" JHopefully, the doctors will report on a larger study and long-term to see if the
+ }" c. I3 k; i# S4 C( \response off Sprycel is sustained.9 u4 l5 A, c0 s9 r4 J {# K
7 k* G/ e z7 u! E1 PBest Wishes,
, N$ l: R2 |0 J# H$ c/ Z/ T2 k' UAnjana9 c, b& l) a, q' s$ Y3 N3 T
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Haematologica. 2011 Aug 9. [Epub ahead of print]: ]$ Y/ c6 o% z0 G/ w+ E0 t. M& s
Durable complete molecular remission of chronic myeloid leukemia following7 Z/ P+ |% l, \7 _4 a) E4 U
dasatinib cessation, despite adverse disease features.
' E0 q9 z+ b0 p9 t2 O, cRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
$ u# C8 Q8 H, R; l4 `" }( b9 QSource
* V* c J$ V; S' ~6 TAdelaide, Australia;
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Abstract
7 a% ^1 n8 @! b% `9 }% b7 _9 ^Patients with chronic myeloid leukemia, treated with imatinib, who have a0 }+ M$ T+ u8 S3 D! T" S3 a
durable complete molecular response might remain in CMR after stopping/ }( r+ y; M4 ]; P" C$ D* T; L
treatment. Previous reports of patients stopping treatment in complete molecular
; _- E* l N8 J" c! N b$ h1 Dresponse have included only patients with a good response to imatinib. We
- s4 I: a2 ?/ |; [2 Z; u0 k# J: Rdescribe three patients with stable complete molecular response on dasatinib
; y" @/ ]6 f- ~7 etreatment following imatinib failure. Two of the three patients remain in
% j+ _/ a. Y. v# K- O) m* jcomplete molecular response more than 12 months after stopping dasatinib. In
( _- v, S+ ^3 Z. hthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
; F% a, n2 i' I6 zshow that the leukemic clone remains detectable, as we have previously shown in
4 O- o( i( A% u4 gimatinib-treated patients. Dasatinib-associated immunological phenomena, such as& ^5 a! O9 c" E/ t: o b" f
the emergence of clonal T cell populations, were observed both in one patient) `1 j: R! A; o) u8 e6 }
who relapsed and in one patient in remission. Our results suggest that the
# F# P2 T: ]" ~3 @5 Ucharacteristics of complete molecular response on dasatinib treatment may be, I/ x; z J) g
similar to that achieved with imatinib, at least in patients with adverse9 L/ V( R1 S! m2 O
disease features.' ?) s v9 ^) P3 o+ C
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