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。
' |( B" q- ]7 o    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。

作者：来自澳大利亚
, J2 ]! `. w$ V3 L9 \9 m来源：Haematologica. 2011.8.9.
Dear Group,

Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
7 J7 ^, |. \9 [# c/ i7 n0 P5 ?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
remain 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.
( @0 R/ a& Y. h, v2 B
The remarkable news about Sprycel cessation is that all 3 patients had failed
1 @2 @- _# L" Q) sGleevec and Sprycel was their second TKI so they had resistant disease. This is
) Y, D  M! {  K2 |/ w% zdifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.

3 ?$ A: t2 I3 iHopefully, the doctors will report on a larger study and long-term to see if the
' K+ O& U0 a% A: N4 \1 ~! n7 Rresponse off Sprycel is sustained.
; J4 |9 t( {/ M* H( s( ~  }  H
4 U0 ?8 R1 y) q9 R5 pBest Wishes,
' C: Y+ R$ _! J1 ^! B- TAnjana

$ j% f- O+ h% ^# [* O, z

Haematologica. 2011 Aug 9. [Epub ahead of print]
/ f2 ^& n; v) ~  ]  YDurable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
+ S0 u6 \! }  Y4 q6 A3 L9 WRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
. C2 O3 J4 [3 |1 RSource
Adelaide, Australia;

9 H. `3 p; O( c9 \5 HAbstract
. J+ \! Z. I5 I* c" }Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
; n: M5 o/ D9 d4 y  S% otreatment. Previous reports of patients stopping treatment in complete molecular
. z& v+ {$ [/ |4 \response have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
/ h9 k5 r9 f0 q* R  o2 d- b/ Btreatment following imatinib failure. Two of the three patients remain in
. l7 S8 o. E+ ~; h* \0 J/ V% Pcomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
4 y: Z, s2 H4 T! [! Lshow that the leukemic clone remains detectable, as we have previously shown in
% L& ^- w. Y% B4 ~* ~imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
6 ^+ S* E, K# m3 u" Y2 ~the 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
$ i$ D* y  P/ dcharacteristics of complete molecular response on dasatinib treatment may be
: U4 I" H, c$ m$ g- Osimilar to that achieved with imatinib, at least in patients with adverse
disease features.
& e3 \& ~+ H. A& C

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。
: ^) Z5 p2 [3 J3 O& N    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。
5 Z; I0 f" H8 @$ ~3 k! I% g
作者：来自法国STIM试验
2 |; H2 [# K/ F! B# n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