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。
, y7 E' d/ S% Q( B$ i+ H4 t    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。
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作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
1 O5 B& {6 P3 p- o0 x2 p1 [Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
' m, A( w$ G: k3 Itherapies. 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
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
0 _1 L+ k0 S  Ldoes spike up the immune system so I hope more reports come out on this issue.

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
, W0 x# [, X% ?' ?6 {different from the stopping Gleevec trial in France which only targets patients
7 l* l$ g/ o" b5 a( F! W% nwho have done well on Gleevec.
* N* |( P# c, F4 t2 f2 x
" o; Z5 r  ?- b  E* fHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
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5 @* S! S. w4 T# c7 }/ x( IBest Wishes,
Anjana
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. b7 P- I) \) T- b& ]Haematologica. 2011 Aug 9. [Epub ahead of print]
# p  h: ]  M: [2 k# vDurable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
* h6 _. j5 [6 V5 B/ sRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
# t$ v7 ?) F2 J3 xSource
Adelaide, Australia;

Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
+ C7 k7 y& N/ D$ C* g: A$ odurable complete molecular response might remain in CMR after stopping
7 _8 Q1 g% e) t, h8 etreatment. Previous reports of patients stopping treatment in complete molecular
2 p# ~& T# U0 @, q8 r# d* Lresponse have included only patients with a good response to imatinib. We
: }2 {5 H& F9 g$ kdescribe three patients with stable complete molecular response on dasatinib
$ d' D; w  K3 {3 Ktreatment following imatinib failure. Two of the three patients remain in
/ N+ m" x0 H/ X* L1 jcomplete molecular response more than 12 months after stopping dasatinib. In
/ M+ ]; T1 |& t& I1 Athese 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
% L8 M% y5 X* w4 N- timatinib-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
  z- d7 M% W, U$ T( ~% Jcharacteristics of complete molecular response on dasatinib treatment may be
% \7 w3 @6 Z% T1 P2 S) b/ Usimilar to that achieved with imatinib, at least in patients with adverse
disease features.
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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。
" j8 z& A6 b; d# u4 I1 U    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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# ^# T: b4 @9 H  R2 Z作者：来自法国STIM试验
- M6 |3 N+ j, M9 a% |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