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。

作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,
* X& D' c: z! }5 B
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
! }1 `. ]0 `, r0 d( stherapies. 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
+ O& t) v7 ^4 E5 f3 V2 fremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
$ \$ V( s9 Y9 s! v+ i! i9 ~does spike up the immune system so I hope more reports come out on this issue.
) S  O4 g" u. w/ Q/ q5 _
( F# C5 A# J' t0 V: nThe 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
" K+ I1 T* ?. q- x7 [different from the stopping Gleevec trial in France which only targets patients
# F9 n* P: N! w: j8 swho have done well on Gleevec.

5 p; z, c/ Z0 d/ C; b% E5 w5 [Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
- G* }+ |4 |" I, Q9 {4 q
Best Wishes,
Anjana
4 n3 n0 i) ]7 h; C: Y! ]1 F! ^! Q
7 P1 M2 I0 d5 N3 c" Z# {
: f6 x: z9 O! L5 N6 q3 M4 n
% j1 U& E! i7 n& f4 V/ HHaematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
, _( a9 i( s! Q3 }Adelaide, Australia;
' E: k) T  r5 l2 }7 D3 P: y% u
# ?' m: }# c. n& bAbstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
6 P# n7 X1 v; y* c. c1 Y0 Htreatment. Previous reports of patients stopping treatment in complete molecular
2 t- w# s6 }7 i: ]" C- s* aresponse have included only patients with a good response to imatinib. We
# p# J2 l1 C! u# b/ e9 j/ Bdescribe three patients with stable complete molecular response on dasatinib
: ?2 j6 l" s4 h; @1 w3 b3 ftreatment 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
- f8 D) V, Y; A. g5 @" oshow that the leukemic clone remains detectable, as we have previously shown in
- l6 f) C, g, U; m) T8 Limatinib-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
. \, \4 A) g8 Y" H' X, N+ Hcharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
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。
    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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5 N/ p) R9 `) }& i- c# V- ?, i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