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。, Q, i! q$ c |/ ?, W" h& ^) q' d
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。' a [5 d# q6 S' W
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作者:来自澳大利亚
3 s0 {0 }; k. T e0 B来源:Haematologica. 2011.8.9.
' Y9 R$ H2 ~6 V0 ]/ sDear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
2 m1 L, ~: j+ ktherapies. Here is a report from Australia on 3 patients who went off Sprycel
, c1 v( V- ^- |# aafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients5 c& C9 S: ^7 `% F2 ]
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
! M, h/ e' l9 idoes spike up the immune system so I hope more reports come out on this issue.
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The remarkable news about Sprycel cessation is that all 3 patients had failed
, }- i9 O/ D: \+ A9 {, Z! e' i/ D+ sGleevec and Sprycel was their second TKI so they had resistant disease. This is' Y' H: i4 S( q8 m# u0 |* M4 e
different from the stopping Gleevec trial in France which only targets patients
" {7 L2 u' A0 k) T2 ~5 Swho have done well on Gleevec.
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. P7 | W7 t: S- t- H! ^( M* ^" PHopefully, the doctors will report on a larger study and long-term to see if the( h4 Q) x1 ~, D2 ^3 b' Z4 r
response off Sprycel is sustained.
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, P! z' U8 n' Z: i, g; O* EBest Wishes,0 e; v! n# q' O" b; V( D
Anjana" h, r5 M4 V& L5 g. S5 i
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Haematologica. 2011 Aug 9. [Epub ahead of print]! m1 S& @9 ?% k6 ~2 K! G, P
Durable complete molecular remission of chronic myeloid leukemia following
, a, H0 h/ U/ E9 `9 ydasatinib cessation, despite adverse disease features.
. g8 l. ~$ c) Q9 U- c- g: c! W( x2 IRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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6 M1 ?; D. r) r( M: c0 AAdelaide, Australia;
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* _9 R* H' P) g' Y' OAbstract
0 v# F( l, g0 Y" U [- M, CPatients with chronic myeloid leukemia, treated with imatinib, who have a2 Q5 m+ N+ L8 G; o u) D
durable complete molecular response might remain in CMR after stopping, M; B0 d/ t% G
treatment. Previous reports of patients stopping treatment in complete molecular
4 z: H x0 b; {! F& K4 v: Eresponse have included only patients with a good response to imatinib. We; |5 D3 i8 T! [* u
describe three patients with stable complete molecular response on dasatinib' d$ n# W; H7 v1 A$ l
treatment following imatinib failure. Two of the three patients remain in8 ?( k# ]1 f5 A
complete molecular response more than 12 months after stopping dasatinib. In4 {# N& q4 c: O. D7 U
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
4 @' S% {9 _5 E& k$ |; R: [show that the leukemic clone remains detectable, as we have previously shown in' I, ?: d, e3 S$ C4 ?
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as8 [& ?2 p, \# Q) g, [: C
the emergence of clonal T cell populations, were observed both in one patient
( o: s2 C: X) \# x+ twho relapsed and in one patient in remission. Our results suggest that the
0 L' L: D, N% N' n, G1 dcharacteristics of complete molecular response on dasatinib treatment may be# h3 J% e& y( G5 M% P1 |& D
similar to that achieved with imatinib, at least in patients with adverse! Q" C$ Y& ~6 D: o2 l! e
disease features.
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