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。
- L# Y2 d6 c# y3 M) {6 R/ q8 [1 I 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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, O) H" w$ I; e作者：来自澳大利亚0 E/ S7 c X! @! L$ X8 s
来源：Haematologica. 2011.8.9.8 D3 }0 I0 j3 g) F; Q) \3 X/ |
Dear Group,
w/ [4 a; E7 v/ b+ Y* R: Q. a2 q5 a: J6 K* Y& l
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
- V$ ~# M) t3 N7 f( u. F6 @- Gtherapies. Here is a report from Australia on 3 patients who went off Sprycel& i# {- @$ S W8 C; H
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
* T0 g5 u! j" e+ r3 {: |remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel" _, L+ h4 j5 D( `
does spike up the immune system so I hope more reports come out on this issue.7 ]& e, D6 y' Z9 z+ D
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The remarkable news about Sprycel cessation is that all 3 patients had failed
+ h( d, n! C* \. ?8 iGleevec and Sprycel was their second TKI so they had resistant disease. This is3 A. L# n0 L% p- E1 ~# C
different from the stopping Gleevec trial in France which only targets patients
. }& T) p7 i6 P( z+ k' J) ?" ywho have done well on Gleevec., g2 U% }- ^# ~
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Hopefully, the doctors will report on a larger study and long-term to see if the! m1 O2 d$ X- C$ ?3 t/ K$ {
response off Sprycel is sustained.+ t ]+ M; @2 D. J2 J4 M9 g! M& D
* Q# H* q9 f& OBest Wishes,
0 Y; B2 a: _1 m. t5 sAnjana: o ~% `) \- ?; j+ m8 G, O
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Haematologica. 2011 Aug 9. [Epub ahead of print]
7 N! w5 n9 b: x9 ~: rDurable complete molecular remission of chronic myeloid leukemia following7 @4 k, ^9 t, R! X4 s
dasatinib cessation, despite adverse disease features.
( d! x) F$ S" CRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
e+ B) d, C9 y4 V! SSource/ T& w G+ F# P3 ?2 y, N( a
Adelaide, Australia;( r. t+ ]0 F2 P" h8 y
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Abstract
5 {) _4 c' o% P4 qPatients with chronic myeloid leukemia, treated with imatinib, who have a' x; l8 X \; m) c
durable complete molecular response might remain in CMR after stopping
7 H' s! w8 J0 g7 Vtreatment. Previous reports of patients stopping treatment in complete molecular
1 M0 f3 J g* d& U0 tresponse have included only patients with a good response to imatinib. We
0 b+ F% g1 Q& c' M( M! Odescribe three patients with stable complete molecular response on dasatinib9 a0 F1 w7 ?8 D. Q1 G( S' L: B
treatment following imatinib failure. Two of the three patients remain in* a9 G/ b4 N% ]. L( G" r, ^+ D
complete molecular response more than 12 months after stopping dasatinib. In
# x P& }) H* ^$ z$ _7 S' l% k# ~these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to8 `$ h: A" z; J" U
show that the leukemic clone remains detectable, as we have previously shown in
$ u7 |& _9 `4 e9 T/ }8 himatinib-treated patients. Dasatinib-associated immunological phenomena, such as' {! z! z, w* x# b$ X5 G% x
the emergence of clonal T cell populations, were observed both in one patient9 D6 [" h& i1 N5 X7 P/ B4 m
who relapsed and in one patient in remission. Our results suggest that the/ E! `. z; O- U+ ^# b! l
characteristics of complete molecular response on dasatinib treatment may be
( [1 [$ W) ?' xsimilar to that achieved with imatinib, at least in patients with adverse
7 o2 b7 k- e5 Xdisease features.
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