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。
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5 z5 O# j& p+ P+ ?3 r作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,

" Z0 J/ f+ Y$ V* ^. VSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
+ d- x5 h7 k8 M. L# Ftherapies. Here is a report from Australia on 3 patients who went off Sprycel
; _$ O. R) W7 r( n8 p0 Z/ vafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
+ [! B2 D9 F$ B2 s) J$ M, A) [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.

The remarkable news about Sprycel cessation is that all 3 patients had failed
3 q, a  }8 Y5 n2 w4 CGleevec and Sprycel was their second TKI so they had resistant disease. This is
% z% v" s/ w4 }  mdifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
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! [5 h( }6 T  S" oHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

; `) Y: z+ a0 X9 VBest Wishes,
Anjana

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Haematologica. 2011 Aug 9. [Epub ahead of print]
6 r' B0 q  A; h4 Z5 L6 CDurable 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
Adelaide, Australia;

Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
0 X7 p0 x7 `- s7 v1 {5 y, Fdurable complete molecular response might remain in CMR after stopping
" {8 @% }, z: d0 H! W1 M) Utreatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
+ c. q5 t( p7 i0 j) edescribe three patients with stable complete molecular response on dasatinib
8 }1 m  |$ o# rtreatment following imatinib failure. Two of the three patients remain in
) l% `. `6 I/ C! Icomplete molecular response more than 12 months after stopping dasatinib. In
% J8 E' K& ~: w% ythese 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
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
( i- i' o: o3 p) o" qwho relapsed and in one patient in remission. Our results suggest that the
1 f# b2 `. ^/ Z2 ccharacteristics of complete molecular response on dasatinib treatment may be
& T  Y5 B9 Z% v7 q- Z5 ^  c+ ?( _) msimilar to that achieved with imatinib, at least in patients with adverse
* Z0 {! y1 P6 }' F' j" qdisease 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。
    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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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