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。

. a" z; F* Z" {8 U) w6 k# r作者：来自澳大利亚
2 s7 }8 H6 l2 C7 r5 C7 K来源：Haematologica. 2011.8.9.
. _, t* I! b. J: }5 FDear Group,
2 E. ?8 k, Z8 ~& n
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
2 V) k% ^/ h# ~/ |  Vtherapies. Here is a report from Australia on 3 patients who went off Sprycel
8 k  w" ]! f! }+ M) Oafter 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
4 m# w: W4 |" c0 I$ C/ wdoes spike up the immune system so I hope more reports come out on this issue.

3 {( [( A9 Q9 o" FThe remarkable news about Sprycel cessation is that all 3 patients had failed
% o6 x5 s* M4 ^4 l: A( H3 BGleevec 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
) A4 z( p* `& W. N% N5 L4 E. bwho have done well on Gleevec.
2 K6 t, O# t) [+ l
4 ^0 M; t' z: X# _* \7 ]0 hHopefully, the doctors will report on a larger study and long-term to see if the
! g9 Y$ q3 f0 i0 ]1 X+ presponse off Sprycel is sustained.
" U- y8 {# ^6 t  p
. M' u. x% e2 N2 }6 G1 N5 n( vBest Wishes,
+ U- q, U1 J3 m! b% m- w) z* eAnjana
# y( |, f& j5 d9 f  ]2 B$ V
9 l# }, E3 `: \  j. h, N1 D. P
- H+ L+ G% k" |/ h
# M  g1 o8 v/ C" h* [- {Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
* y; P' h4 i$ Q2 n  i4 q1 o% @dasatinib cessation, despite adverse disease features.
  J2 `% a% ]' `" a2 m' G4 iRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
7 q* q$ G# `2 YAdelaide, Australia;

Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
. s& V, X4 ~' w  |) L  a7 Z. Xdurable complete molecular response might remain in CMR after stopping
+ P  F7 I" L8 c% D% Gtreatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
/ n9 ~. ~" L! q8 m; s4 ~4 Cdescribe three patients with stable complete molecular response on dasatinib
3 `7 R5 ]( |5 ktreatment following imatinib failure. Two of the three patients remain in
( E" D1 T* j5 U* H! |7 l3 dcomplete molecular response more than 12 months after stopping dasatinib. In
these 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
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
& Q1 K7 {( {. Y  }, A* q+ Wcharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
8 D* ?/ i5 }0 x% r. v/ `' ~disease 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。
! C% I, h! F: m) n. K    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。

8 C8 e( b" d, \$ v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