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。
' t: }. T  ^- @: S- _1 ?9 y: @    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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7 {" M% X  t6 a) b, l! j: S& P作者：来自澳大利亚
  v, r6 ~) \, N来源：Haematologica. 2011.8.9.
Dear Group,
2 H, e1 T8 ?  K; G# Y" I* X' N, [& N
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. Here is a report from Australia on 3 patients who went off Sprycel
: X* `$ c* @3 }- Nafter 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
1 R  `; f! @6 g' cdoes spike up the immune system so I hope more reports come out on this issue.

7 U. A& _# f6 B" u) c8 `The remarkable news about Sprycel cessation is that all 3 patients had failed
& x2 ^- N7 s$ F- ^Gleevec and Sprycel was their second TKI so they had resistant disease. This is
- a  P% T) j  s2 `( [different from the stopping Gleevec trial in France which only targets patients
1 v# u6 o: G( U0 x8 Twho have done well on Gleevec.
) j  z2 v( J& Y' a- F: G6 ~, {( O0 j
7 s% [1 T( e- R/ u! gHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
3 z* |8 \  H9 h8 _8 x
9 \' S" s& F' ^0 MBest Wishes,
Anjana
' A+ @. o* Y" c1 _% D


Haematologica. 2011 Aug 9. [Epub ahead of print]
, X) j5 ]+ Q; E' A7 P+ UDurable complete molecular remission of chronic myeloid leukemia following
/ n: k! g1 L' s" {- g& ~; ]dasatinib cessation, despite adverse disease features.
- e3 C6 z/ Q1 O! O( CRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
5 z% [$ x4 S$ k+ p  h8 z9 \Adelaide, Australia;
) V( z4 o) F* U  y2 l" P
" K- e/ s2 E* ~9 e8 dAbstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
/ o  q6 m+ b+ y  F/ ]+ V% Bdurable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
' s+ K. d0 ~0 Z1 n' e5 ^describe three patients with stable complete molecular response on dasatinib
' y( B/ _7 e. W, L6 h. ltreatment following imatinib failure. Two of the three patients remain in
1 Y( u1 e# a6 K3 H7 f1 kcomplete molecular response more than 12 months after stopping dasatinib. In
; v) d1 H3 L6 s" B! 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
imatinib-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
8 A! n( [5 z0 ucharacteristics of complete molecular response on dasatinib treatment may be
' Z0 H9 `4 N' rsimilar 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。
6 q& a4 f- y8 E9 \- m- T6 k. ], F    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。
2 I0 w3 {/ |) s    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。

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