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。
5 }9 O; S9 b4 A1 l4 o1 v. 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。" e& s7 F) R7 G' v$ f
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作者：来自澳大利亚; I* h6 m7 K$ n4 `+ c, h
来源：Haematologica. 2011.8.9.
6 U7 I3 X3 X* ~Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
) k( l) h$ w6 K/ C# C/ q8 ctherapies. Here is a report from Australia on 3 patients who went off Sprycel
/ Y. a& Q" G8 N" _after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
, E' A! Z: T6 N9 M: ~remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
: w5 ?, Y* y* E& Idoes spike up the immune system so I hope more reports come out on this issue.: K! d) O+ K" s( w, K3 H" r' r' f
; }, R* r7 X( I, c+ R' Q! JThe remarkable news about Sprycel cessation is that all 3 patients had failed4 @# F+ F% T' V5 K- G
Gleevec and Sprycel was their second TKI so they had resistant disease. This is i9 P+ R5 s& v3 V+ S2 S! R
different from the stopping Gleevec trial in France which only targets patients1 d: N! s) o2 _. {. D8 [& r) Q- ~
who 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
- t9 c7 p: r5 i9 dresponse off Sprycel is sustained.
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Best Wishes,
* T9 n+ {. Q! }9 L. s& ?: LAnjana0 B0 M5 q& _" B2 V; o5 p
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Haematologica. 2011 Aug 9. [Epub ahead of print]+ w1 l0 _' D, |& Y( X
Durable complete molecular remission of chronic myeloid leukemia following
, b) J& G! ^5 Q, v- |& j/ idasatinib cessation, despite adverse disease features.
. A n f( a3 WRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.% Q9 q' M$ _ p: {
Source1 _/ X) }9 K6 X) a
Adelaide, Australia;9 c! _& J' W" g7 U7 t* Z [( X
# ?9 T, R; J. e9 wAbstract3 {8 s! z* g. [
Patients with chronic myeloid leukemia, treated with imatinib, who have a
" k; S$ f+ |; K. T' n2 `durable complete molecular response might remain in CMR after stopping6 B, C6 G) f2 T: U
treatment. Previous reports of patients stopping treatment in complete molecular8 `7 n M( W( d# d: T Q
response have included only patients with a good response to imatinib. We$ ]4 W! @7 d' s9 }# L. @
describe three patients with stable complete molecular response on dasatinib) f! Z X. G' v2 F
treatment following imatinib failure. Two of the three patients remain in
5 x2 a0 |/ s: M2 n2 K2 L4 O! Ncomplete molecular response more than 12 months after stopping dasatinib. In+ i8 q" }' ?( V2 X! O: e3 b5 e
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to" v U6 _% Z" |7 y y" V% H
show that the leukemic clone remains detectable, as we have previously shown in0 U. H k5 k- d' D8 J5 o
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as8 y8 u; L% a4 e! r
the emergence of clonal T cell populations, were observed both in one patient/ C& Y* h9 O$ u3 f' G+ d
who relapsed and in one patient in remission. Our results suggest that the' h {7 S0 w3 q/ v9 |
characteristics of complete molecular response on dasatinib treatment may be Q. c! R! W# O* y8 P
similar to that achieved with imatinib, at least in patients with adverse
1 b* J( U S% i% jdisease features.
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