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,

Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
! T" d* `3 l6 X2 atherapies. 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
% X/ H4 `/ m& N6 `remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
does spike up the immune system so I hope more reports come out on this issue.
  Y' c# N# [; f/ Z  C3 j; n1 Z
The 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
% X, S# g- N' {5 [different from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
3 r" j! j% s, V
8 u/ `6 S. n  ~# L$ B$ _* qHopefully, the doctors will report on a larger study and long-term to see if the
& B3 k. Z$ {" S8 p" Eresponse off Sprycel is sustained.
7 b) O7 A8 F, u  w
Best Wishes,
! l; J) z0 M$ zAnjana
9 l" M* ~& N$ g

! W' D, n3 f' @
. y+ p2 i" u5 MHaematologica. 2011 Aug 9. [Epub ahead of print]
: U# u5 q' u2 n5 e5 n: ODurable complete molecular remission of chronic myeloid leukemia following
5 \  @* I, T2 {9 Jdasatinib cessation, despite adverse disease features.
* n5 V" A8 T- A2 e, u' g4 z4 oRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
9 X. h+ t7 k* l1 o1 z9 O7 s: GSource
( z- v0 P+ }  T' s! }# K  d0 U. ]" rAdelaide, Australia;

Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
; X, k* O+ Z. y1 k5 E3 T* p7 d! B( j% |durable complete molecular response might remain in CMR after stopping
( ?2 y( F. d( Z1 a) ~treatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
3 E/ _. F8 |' U  V, P8 E2 C+ Jdescribe three patients with stable complete molecular response on dasatinib
; t: u2 t0 |4 ~0 |0 Etreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
- b5 @2 F) G) Z. l( [( O$ p. athese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
) O. J+ P, m% Ushow that the leukemic clone remains detectable, as we have previously shown in
2 ]! t4 [( T0 h% z' A' D3 j6 mimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
+ S7 i, E5 Q4 h# Sthe emergence of clonal T cell populations, were observed both in one patient
' l0 `8 h( w& {% Wwho relapsed and in one patient in remission. Our results suggest that the
( C6 @* B7 T( I+ ^% vcharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
9 j$ E& i9 Z7 M  ?6 d; r) Ndisease features.
5 z: C! }: {9 k5 d5 P

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。
' D' j! P1 O% Q$ }3 U    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。
% K* e: T: ^* B; }2 l  _
+ R) E4 a5 K/ Y3 N0 Q" q; h  C# l2 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