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。
( _3 p+ r2 Z ^' \ 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。! G2 K8 y3 Z: G9 _. H2 x* V
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作者：来自澳大利亚! I/ N o! M' B- A: {% T
来源：Haematologica. 2011.8.9.
9 w A: K! n: k" f' \! y7 Y/ X ZDear Group,
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$ q$ @. K4 n! x. t; ]7 QSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
" }$ ? e6 r1 R% l+ C4 Vtherapies. Here is a report from Australia on 3 patients who went off Sprycel. n& ]# U+ j0 Z
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
9 p }6 p0 f, i; k8 v) g Zremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel" c/ W; t' A0 q! f9 }# H
does spike up the immune system so I hope more reports come out on this issue.% o7 B$ N8 i+ u0 x" z$ p
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The remarkable news about Sprycel cessation is that all 3 patients had failed
) t5 H! R, X9 e8 V& _" wGleevec and Sprycel was their second TKI so they had resistant disease. This is
7 t( L& ^' Y2 Mdifferent from the stopping Gleevec trial in France which only targets patients
5 O7 f, M) Q7 K/ W1 Kwho have done well on Gleevec., F' u9 q- Z1 n0 \# G( M2 {. T
% B' k/ g- {; `8 J# @" h1 e9 D
Hopefully, the doctors will report on a larger study and long-term to see if the
% N7 [1 a# G6 }: l6 w- S' K5 Z5 Vresponse off Sprycel is sustained.! l8 K* \( V( m" y+ R7 K. Q' T' m
& h* h6 y" ^! T$ k8 r, K( r* s8 ZBest Wishes,; v: x. d. V4 L9 {
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]- p" f- J% Q1 f" o) c' P
Durable complete molecular remission of chronic myeloid leukemia following
+ ^8 v! l. B: l) ^' J* Q3 Hdasatinib cessation, despite adverse disease features.
+ s4 K& l, C- y+ P% b' r& {Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
5 {7 C4 e" F1 Z7 b4 S$ {3 ISource
6 Y; X0 a$ P, @: o4 OAdelaide, Australia; n0 Y) m/ }3 N) `5 y" a- S/ l; A& c
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Patients with chronic myeloid leukemia, treated with imatinib, who have a3 x! H4 ^+ ?: [' R5 J9 R; L
durable complete molecular response might remain in CMR after stopping. ~" x* d& l' d7 A
treatment. Previous reports of patients stopping treatment in complete molecular1 \ M' ?6 x6 c& S1 t% B; b
response have included only patients with a good response to imatinib. We$ J( _& s7 Z3 n- A: S# E
describe three patients with stable complete molecular response on dasatinib' A# u- U' x7 J4 `9 J
treatment following imatinib failure. Two of the three patients remain in7 q+ ]$ j+ o( E& M( ], y
complete molecular response more than 12 months after stopping dasatinib. In: a3 \* X9 Q3 n" }
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to4 [; j: {" G+ F+ ]) r" j7 z! U3 |
show that the leukemic clone remains detectable, as we have previously shown in$ e- q9 N; O) i- [0 Y8 |
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as. t4 H v" h5 n: y, L! @
the emergence of clonal T cell populations, were observed both in one patient
, p# r0 l5 _/ [: Q* S# Awho relapsed and in one patient in remission. Our results suggest that the
0 Q* W$ W9 k# Y+ zcharacteristics of complete molecular response on dasatinib treatment may be( x+ g2 `7 b5 |! T
similar to that achieved with imatinib, at least in patients with adverse' [7 x/ f @4 x7 {/ ^
disease features.
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