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。
' `2 m0 I9 w& Y    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。

# i: L- @  H( q" O' O) Y作者：来自澳大利亚
# ~0 l* y  F- S4 t$ U: Z7 B1 \& T来源：Haematologica. 2011.8.9.
Dear Group,

Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
4 q+ q( b+ y5 P2 Y1 ]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
7 ^& f( \1 E  P+ S. L& iremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
* ~, O+ R) t$ Jdoes spike up the immune system so I hope more reports come out on this issue.
( I4 k( _9 {4 Y/ v  O' Y2 n
0 U+ d& z' T6 t/ F3 ?, lThe 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
( K0 F8 Z' g& m! ^5 D1 Lwho have done well on Gleevec.

Hopefully, the doctors will report on a larger study and long-term to see if the
/ ]/ T6 e  h6 T) H' u1 s4 Vresponse off Sprycel is sustained.

" N5 l1 s) l3 P% T6 T% `% E3 RBest Wishes,
, V+ x3 w+ \* k$ fAnjana
! L+ M# T$ p/ R# ?4 `


) u: q# ]3 ?6 J; k$ {' d. AHaematologica. 2011 Aug 9. [Epub ahead of print]
& t( T6 H' J. E; i: S/ b& x% S) wDurable complete molecular remission of chronic myeloid leukemia following
2 |" ]7 O- r/ Y- Q; @8 Z7 k# edasatinib cessation, despite adverse disease features.
6 W2 P* r6 W' Y* @3 ERoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
Adelaide, Australia;
# b0 g- q8 D9 |# ^  y
1 @) f- D9 a  C7 G' s& @Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
9 S! n7 E" Q: _+ L% e& Z- [durable complete molecular response might remain in CMR after stopping
9 n9 |5 d. t2 O' T7 Ltreatment. Previous reports of patients stopping treatment in complete molecular
) O# E9 U" b; ~8 ?- N! I) I4 `response have included only patients with a good response to imatinib. We
' [- v4 ?- }" k8 ^2 Bdescribe three patients with stable complete molecular response on dasatinib
4 N# i/ }& o- h4 ytreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
% O% M: W( [" |( ^$ pshow that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
& Q) Q% s: ~  z5 v1 qwho relapsed and in one patient in remission. Our results suggest that the
3 S. M" p5 E# ^; A* ocharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
* k' W0 t& g4 Wdisease features.

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 i. S- K" \) w6 M. 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。
! J% e3 N! ?: \    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