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。
! D5 V5 q9 T- R 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。# ]9 r/ T: n4 o! X( @ n1 X
; g0 @4 ^! I0 i6 ]* \; p( T( Q作者：来自澳大利亚' M6 ?. Q$ @+ A& C
来源：Haematologica. 2011.8.9.
& n; U5 l' h3 B/ e6 d% d7 F0 v9 [Dear Group,
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! J3 X4 ?7 w) B% y, f% |2 KSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
/ o+ U9 ~* l: B7 i$ qtherapies. Here is a report from Australia on 3 patients who went off Sprycel7 Y# v: D2 E2 E! L
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
* i1 b( }7 H( S( L2 bremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
& V' c; Y4 c7 q* G1 y; @4 t, G! `does spike up the immune system so I hope more reports come out on this issue.
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4 S1 y/ h9 e8 {! V# G1 M2 I' `! NThe remarkable news about Sprycel cessation is that all 3 patients had failed4 o, G, Y K( E; L' [
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
/ ^- E" f, x2 V ~" `+ c- S, R c( N1 ^different from the stopping Gleevec trial in France which only targets patients
5 l% l& c2 G+ g# q% y! Zwho have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the
( q f! N8 f" @! N4 v7 Vresponse off Sprycel is sustained.
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Best Wishes,& \+ D* i- X# _; v1 [
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]. e) L3 a T& u
Durable complete molecular remission of chronic myeloid leukemia following
& X. e0 X% p, V" C- ~; B8 V+ k9 B9 j4 C; fdasatinib cessation, despite adverse disease features.7 ?4 l. ]2 [$ }
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.$ y# n; g% W+ ^. y$ p
Source
! L: b c1 L; B# P- o8 \1 ~ nAdelaide, Australia;
, Q8 o8 o+ c$ [2 P& ]4 [5 S3 E y9 k3 V+ \& y. ?$ r9 v: ~
Abstract* |: `! `1 b8 U* |4 v9 c) ^
Patients with chronic myeloid leukemia, treated with imatinib, who have a3 w) t3 n1 x9 F' V# d
durable complete molecular response might remain in CMR after stopping
( Z M2 V! W1 etreatment. Previous reports of patients stopping treatment in complete molecular1 \3 v( C5 J$ M
response have included only patients with a good response to imatinib. We- K; a' F7 h$ v1 t/ F
describe three patients with stable complete molecular response on dasatinib* i% C% o/ t5 d+ U9 `' I: @1 ?- }
treatment following imatinib failure. Two of the three patients remain in4 @* U( M: c: z7 n, Z: h2 K% a \! [
complete molecular response more than 12 months after stopping dasatinib. In
( _0 Q& j* A9 h k1 b! a! Wthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to4 _1 ~; g/ o* V: n* k2 l, [2 T
show that the leukemic clone remains detectable, as we have previously shown in
7 r/ a$ E- t6 wimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
, M3 q, S$ J1 Bthe emergence of clonal T cell populations, were observed both in one patient
6 N) b( g7 w/ }+ Z. @# `who relapsed and in one patient in remission. Our results suggest that the
9 S% w) Q9 @% f( E% echaracteristics of complete molecular response on dasatinib treatment may be6 w3 Z- U1 L8 B& j& a7 Y5 q, `3 Q C
similar to that achieved with imatinib, at least in patients with adverse
( N* F8 Y. I- V8 q2 ]disease features.
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