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。
    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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作者：来自澳大利亚
1 c# v0 s  y1 d/ t  S来源：Haematologica. 2011.8.9.
. S6 Z* h& p3 L  @Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
' t/ K6 B5 K; D' }; S, Ctherapies. Here is a report from Australia on 3 patients who went off Sprycel
% D7 O$ B8 M0 m. {- dafter 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
: A  f( i6 l0 K$ ~/ x$ {" jdoes 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
" _# o7 ?+ ]8 W( V) W, B: s* fGleevec and Sprycel was their second TKI so they had resistant disease. This is
! X8 C7 @) }" R- ^6 t8 N/ J+ I; mdifferent from the stopping Gleevec trial in France which only targets patients
who 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
response off Sprycel is sustained.

Best Wishes,
Anjana

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  }2 A, I6 u/ Y0 ]& m
Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
4 }% B: D$ C4 @8 idasatinib cessation, despite adverse disease features.
+ E9 l3 t8 J0 n' s8 A* q( Q. P8 VRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
Adelaide, Australia;

2 s5 C1 H* }. x4 S8 a- P; z) R0 SAbstract
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
response have included only patients with a good response to imatinib. We
2 g, y6 D2 e4 Gdescribe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
8 Y, S9 j+ M3 ?+ \( w$ {complete molecular response more than 12 months after stopping dasatinib. In
4 D# s+ B' ^1 ~6 c. ethese 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
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
' D: {+ @/ ?$ k0 ]$ Z* ~8 Fthe 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
2 g# F3 q9 X( ?characteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
6 r$ c2 C+ X- r: g! B0 Q" vdisease features.
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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。
    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。
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作者：来自法国STIM试验
' f- m# c' o6 m4 u- N$ j6 C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