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。5 O& ]& J0 N6 H6 z* M
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。$ u5 \- O1 f1 N0 ]7 ^) R- s# E
& E4 x/ r" j" N( V作者:来自澳大利亚" J* U4 F' ^/ W6 C
来源:Haematologica. 2011.8.9.* q/ ^9 b! Q. H" F8 f
Dear Group,
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/ z, S, x& I# ^& G9 oSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML* f' b4 T$ d7 F: _. F2 @0 x
therapies. Here is a report from Australia on 3 patients who went off Sprycel- b: y% d; z! o$ j# o! _
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
2 `( [$ u0 r; \# Q9 Q: r$ Mremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel' L) t7 c6 N d7 L- B7 m4 `8 ]! n
does spike up the immune system so I hope more reports come out on this issue.! l* i2 f; [# h+ f- E& `
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The remarkable news about Sprycel cessation is that all 3 patients had failed
3 {+ S4 n- K0 k3 b9 z: eGleevec and Sprycel was their second TKI so they had resistant disease. This is
+ z# o( _: F; f. |* qdifferent from the stopping Gleevec trial in France which only targets patients
2 T' U6 r" }3 S3 L, rwho have done well on Gleevec.* }8 o: b S% ^" a6 ]! j0 J
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Hopefully, the doctors will report on a larger study and long-term to see if the
1 r+ b' C( u" X! |2 C1 Zresponse off Sprycel is sustained.
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Best Wishes,
+ e3 {5 } I3 T a, NAnjana( l2 e; r: [9 q u8 m) U5 A5 }
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Haematologica. 2011 Aug 9. [Epub ahead of print]1 S0 d+ ~5 Z6 Z: t: F
Durable complete molecular remission of chronic myeloid leukemia following
6 v0 X0 g& H# q/ i. idasatinib cessation, despite adverse disease features.
, W$ R9 ^4 ?6 vRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.' o+ _7 E8 C0 D+ m
Source8 R6 O8 T; k" l& G& N6 m8 _3 }/ u) _5 Z
Adelaide, Australia;
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# `- ?9 @/ |& D" j" i. ]Abstract
) s( T5 J* n6 v3 K. Q& w- |6 X+ APatients with chronic myeloid leukemia, treated with imatinib, who have a/ v) N2 R' O1 E; C G
durable complete molecular response might remain in CMR after stopping2 k/ Q& m( t% y/ a! x- D. W
treatment. Previous reports of patients stopping treatment in complete molecular" ?# x+ j$ K4 a1 T( a f, y: M
response have included only patients with a good response to imatinib. We
A6 K. U9 [* t5 O0 udescribe three patients with stable complete molecular response on dasatinib
( v2 y" O% f4 N- T) _treatment following imatinib failure. Two of the three patients remain in6 m" @% B% G( _
complete molecular response more than 12 months after stopping dasatinib. In0 a; O _6 w" _) F7 z/ {
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to' k% Z; e& }! k
show that the leukemic clone remains detectable, as we have previously shown in
/ W3 O& { H: X, L6 cimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
. x# f9 P5 C) V" Zthe emergence of clonal T cell populations, were observed both in one patient) A& ~: M( x9 i' K1 W3 v( M
who relapsed and in one patient in remission. Our results suggest that the
( U5 ^! m$ I# _- {* l6 G4 b7 c/ e7 Jcharacteristics of complete molecular response on dasatinib treatment may be
" D+ E+ Y E0 C- E e2 Gsimilar to that achieved with imatinib, at least in patients with adverse, O. `0 ^- C' |0 U& @ {3 J* [5 E
disease features.
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