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。( z* G0 d9 j& r$ d3 l; I
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。& F3 `1 M' A/ C! e) B; Z
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作者:来自澳大利亚
( Q) x- A% U; b! ^2 W来源:Haematologica. 2011.8.9.) s1 d7 w- w/ j( X: U, L& i; ?
Dear Group,
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: ^* J( A# t. V KSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
R% V* D, i4 N& h) \. _: W2 @! Dtherapies. Here is a report from Australia on 3 patients who went off Sprycel: i5 }' U% W( t1 T% S9 c3 w
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients7 J6 n: h6 c1 q( w. n' |
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel( v) L3 n9 G. R4 x0 K+ L% d! F. h
does spike up the immune system so I hope more reports come out on this issue.1 Y/ F+ H0 P6 ? W' h
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The remarkable news about Sprycel cessation is that all 3 patients had failed# B% o+ d4 M' c% ]: b" A$ o
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
1 i$ X) L3 X0 B& C% Idifferent from the stopping Gleevec trial in France which only targets patients8 ^/ z+ k0 ?( I( s) W
who have done well on Gleevec.; R7 L% v+ W3 i d( k
' U _3 y# Y; tHopefully, the doctors will report on a larger study and long-term to see if the7 i2 q1 Q ^& ?1 d% b! S
response off Sprycel is sustained.7 o ~& f1 r+ \4 ^! H
+ O4 C. ^4 l9 ^& \ IBest Wishes,- G: g! Z5 B7 b+ o" I( y
Anjana L$ l8 u3 o! s4 P
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Haematologica. 2011 Aug 9. [Epub ahead of print], h+ u, D! m0 U% w8 W
Durable complete molecular remission of chronic myeloid leukemia following
- i5 z5 |9 J- C4 ^. Ldasatinib cessation, despite adverse disease features.
& g+ i3 f- P, D" g/ gRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.3 K2 c1 G' s x# }$ ~8 b
Source
: Y B6 M) J/ @3 C5 f" mAdelaide, Australia;, F R" L, ]& y5 S, Y1 T
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Abstract
/ [$ l, Z" s( R6 b5 _Patients with chronic myeloid leukemia, treated with imatinib, who have a& _0 q/ L: u5 t* y
durable complete molecular response might remain in CMR after stopping; v/ Y8 h- A( `
treatment. Previous reports of patients stopping treatment in complete molecular
1 G# u6 d4 u/ N0 m6 X l8 Rresponse have included only patients with a good response to imatinib. We
- u/ w2 r1 @) [. I7 M( Udescribe three patients with stable complete molecular response on dasatinib
; V, B1 w1 r6 `+ B( \! F1 Ftreatment following imatinib failure. Two of the three patients remain in; O, C' k* f! _7 Y: A+ D8 L
complete molecular response more than 12 months after stopping dasatinib. In
: m+ X9 W( Q& Zthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to* _# ?/ Q, q9 M+ ]/ _: q
show that the leukemic clone remains detectable, as we have previously shown in6 g) e Z- a( {
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
' N* W- Y" Y9 qthe emergence of clonal T cell populations, were observed both in one patient' Z1 x3 L7 i) n+ c( _/ e f% ]
who relapsed and in one patient in remission. Our results suggest that the6 O- |( J4 {( g6 N4 r0 O5 z
characteristics of complete molecular response on dasatinib treatment may be" K- F v# y; ?* e& \
similar to that achieved with imatinib, at least in patients with adverse# t, x# ?3 I5 [ V
disease features.
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