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。! v5 f: Z! P7 m/ 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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2 {) l/ m# h/ _1 h. c作者:来自澳大利亚
x8 q$ b7 `- F& V1 w' \/ _来源:Haematologica. 2011.8.9.
2 ~) D1 `% k t: u% Q% ?$ h6 FDear Group,
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( C" T+ f! M4 n( Z& [* hSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML& M: ]2 j0 @& S- Q
therapies. Here is a report from Australia on 3 patients who went off Sprycel
* T6 ^' K6 U$ ? H+ C$ l3 }4 eafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients, J7 f4 e$ C( e7 n
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
4 H. n; M- X$ _does spike up the immune system so I hope more reports come out on this issue.
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! R+ C- ]) L: m* L; HThe remarkable news about Sprycel cessation is that all 3 patients had failed1 p7 W8 a0 n1 |3 N
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
! c- m: A! k0 r3 ]- ~1 x9 b. [5 y8 Qdifferent from the stopping Gleevec trial in France which only targets patients
: Y6 ?7 A# N4 B0 t+ Lwho have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the! i) R, y; k- r" m
response off Sprycel is sustained.1 v. |# Y6 ?5 |
* d: k* n, O8 u+ L" nBest Wishes,! u+ ^2 F9 U9 T& W
Anjana
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* \1 I- w1 f2 M4 b! DHaematologica. 2011 Aug 9. [Epub ahead of print]
" U$ S* {. e S4 p( C# H/ ~' QDurable complete molecular remission of chronic myeloid leukemia following
! A3 C) S* j" N6 m6 rdasatinib cessation, despite adverse disease features.7 L% x1 U3 A: J$ A K5 x: D4 V6 X5 ?& `
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP./ O9 Y0 ~4 o5 d6 m+ Z- ~
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Adelaide, Australia;
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$ | R8 O$ `3 iAbstract H3 ?. C: W( d4 L) C
Patients with chronic myeloid leukemia, treated with imatinib, who have a
1 \* [" h' ]4 C) fdurable complete molecular response might remain in CMR after stopping
) P: e- t. i7 ?8 f( P htreatment. Previous reports of patients stopping treatment in complete molecular: B N# |6 b% G& D
response have included only patients with a good response to imatinib. We
0 u3 t1 Y- u7 b& ?, _0 t' X P% kdescribe three patients with stable complete molecular response on dasatinib# n. e8 ` Y$ Q5 z9 w0 f2 q
treatment following imatinib failure. Two of the three patients remain in$ [$ |4 }# i( x5 ]5 P
complete molecular response more than 12 months after stopping dasatinib. In
8 @5 E3 H5 v! H, Y3 Tthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to" R6 a# C! f: j( D( f' \
show that the leukemic clone remains detectable, as we have previously shown in* o9 R: o7 e8 D% L) I
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as; r0 N( s$ n' i: R" l0 `
the emergence of clonal T cell populations, were observed both in one patient% ~# R' X- y8 Z3 S/ M, X
who relapsed and in one patient in remission. Our results suggest that the' Y/ d" E7 {+ l( S/ |7 d* H
characteristics of complete molecular response on dasatinib treatment may be! \% x5 O- p5 |) q" v
similar to that achieved with imatinib, at least in patients with adverse
7 F: {# J% t6 h# ddisease features.
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