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。/ D o3 X1 i( e/ f! b- O0 |
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2 R+ O* l. V& g# U$ A3 ]- j. x# l
来源:Haematologica. 2011.8.9.2 @0 f( {5 h! t- T0 f
Dear Group,/ e4 E$ @7 K* M8 x/ T' F
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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 Sprycel0 e: a) D& H3 z! `; J8 d- e
does spike up the immune system so I hope more reports come out on this issue.5 P. l; H1 L3 m
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The remarkable news about Sprycel cessation is that all 3 patients had failed' R' O9 s- s* \& D! F; U) c2 o, {
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.+ c) d8 V) W) \( ?: A
. 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.$ F9 c# Z# I y% `$ w9 h0 U8 r
z: s! G0 }; g
Best Wishes,
! Q! S: ^; H8 c) M) JAnjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]$ `) w3 l3 ?' U' |2 h5 p& v$ j& D: l
Durable complete molecular remission of chronic myeloid leukemia following0 V4 y8 U! A6 @/ D7 Q( l# F$ W
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) z# z0 _! u4 T' l# v
Adelaide, Australia;" n0 x1 A+ c# V% G5 o
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Abstract- `2 m6 _- S' a4 y f, ?
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 molecular2 q( g- ~2 ], z: t
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: f7 C- D" W y+ O, i
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. In6 Y& C8 z, C' q" L( p" s& w
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to D" V. A( R9 k# ^3 Z4 N
show that the leukemic clone remains detectable, as we have previously shown in6 R6 [: Z9 G2 B# {+ R3 _% R$ O0 x2 o) S
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as3 _) [: r& w' q5 p% o1 t' X
the emergence of clonal T cell populations, were observed both in one patient4 C0 |% ?) U6 ]
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: t% p" S+ h/ j( X7 W
disease features.
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