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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作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
0 w: Y% r$ V, S, `; PDear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
$ v) u! t7 D+ S. M/ Etherapies. Here is a report from Australia on 3 patients who went off Sprycel
( \2 a- M6 N5 \' H) b" p; Z& hafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
8 j" E7 X3 ~6 w! G9 [remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
! y7 _$ z& h7 odoes spike up the immune system so I hope more reports come out on this issue.
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The remarkable news about Sprycel cessation is that all 3 patients had failed
. h" Y; b3 m1 @  w! L+ ]$ P0 I. i( CGleevec and Sprycel was their second TKI so they had resistant disease. This is
different from the stopping Gleevec trial in France which only targets patients
2 F6 p# d9 w  ?) x& ewho have done well on Gleevec.

4 L* ~9 }) H$ v/ |. NHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
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3 P8 I8 [5 O. I" l" r$ lBest Wishes,
1 H# }, L7 G, v' k+ s  HAnjana


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6 r- e* K) U0 y6 q. ]: ?Haematologica. 2011 Aug 9. [Epub ahead of print]
4 E: m4 ?" b& k6 W, l2 i4 p% bDurable complete molecular remission of chronic myeloid leukemia following
9 W2 v+ r% k) Y0 S5 k) S: {' ^. T) Qdasatinib cessation, despite adverse disease features.
2 G8 `' M$ e' k( e9 @% oRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
Adelaide, Australia;
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0 d7 z+ O0 R+ A; K2 eAbstract
: S$ s% Z: `& M- K2 O7 k0 ZPatients with chronic myeloid leukemia, treated with imatinib, who have a
0 U% E) e6 x* M2 w$ [durable complete molecular response might remain in CMR after stopping
/ u4 p' R6 g1 m1 W- t$ {" Ytreatment. Previous reports of patients stopping treatment in complete molecular
: ^0 C- R8 {; L/ S6 u8 Aresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
4 r) d7 \; }; z6 c: R& \complete molecular response more than 12 months after stopping dasatinib. In
1 {' H3 ~! ?5 i$ [( C( X5 rthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
8 m4 [8 s' v  N: N9 r: P3 {: \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
9 Q# B  Y% z8 x. x7 N1 Zwho relapsed and in one patient in remission. Our results suggest that the
* c7 ]. g9 c) V2 F, p3 U7 e) R' l: B. Fcharacteristics of complete molecular response on dasatinib treatment may be
/ ]# k" u6 e1 ?& |. ]similar to that achieved with imatinib, at least in patients with adverse
) v9 ?3 v2 ?2 Y+ B# r9 b9 Q% zdisease features.

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。
9 U8 u6 n# D; r+ ]    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。
$ C3 O5 v3 H" U7 Q) K    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
, \) K/ y. A! R) ]' C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