关于停药的相关内容

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。

/ D  j4 {! D% y7 s6 X' m作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,

Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. Here is a report from Australia on 3 patients who went off Sprycel
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
does spike up the immune system so I hope more reports come out on this issue.
% d* O; U4 ], ^! b* s3 m4 d' }
The remarkable news about Sprycel cessation is that all 3 patients had failed
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
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
response off Sprycel is sustained.

* h. y7 m: w3 {9 o* ]( N1 \' IBest Wishes,
9 g3 C2 N4 h; ^2 `. I6 e$ XAnjana


/ 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.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
$ k0 T0 b. a3 d% b, }Source
Adelaide, Australia;
( a" ?7 e  p* u4 u5 V
Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
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
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
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
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
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 be
similar to that achieved with imatinib, at least in patients with adverse
disease features.
" w, U5 N5 a- T  a/ I

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。
    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。

作者：来自法国STIM试验
来源：EHA 2011.6.会议摘要

很不错的文章，看来马老师家有考虑停药的想法了啊！祝福！

期盼易或特也能停药，但现在觉得是一个梦想！

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