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。1 J- Z7 q' [; ]+ P% A# a* E
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。7 x: T" I4 S4 R, S/ ~) t
8 {5 g$ N9 a/ y6 l7 w, N8 ?作者：来自澳大利亚6 n% a( j ^4 e4 Y
来源：Haematologica. 2011.8.9.' @- R3 D3 d6 O: R9 r, T
Dear Group,
+ Q. L; e& a! [" r5 x
" v% z, }9 a; G/ c& SSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
" e0 B- i3 V% {1 k% p( L/ Etherapies. Here is a report from Australia on 3 patients who went off Sprycel, a4 X H7 ?, Y' h3 Z1 H
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
) T4 |2 K8 {; j% H( _0 f kremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
4 R0 w7 }' u; l% K" f: xdoes 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* e7 Z+ s6 z; T: R7 w
Gleevec and Sprycel was their second TKI so they had resistant disease. This is9 b( i* _( f+ ?9 e6 J
different from the stopping Gleevec trial in France which only targets patients3 O6 `4 u( E" f& N" Y) j) n& I
who have done well on Gleevec./ t) J/ \3 Y8 |) d5 P
+ x% |7 N; z* X; ]$ c' y
Hopefully, the doctors will report on a larger study and long-term to see if the
' k' f! y# l/ g8 Iresponse off Sprycel is sustained.
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5 m( ?' S; g, B( A" ~Best Wishes,/ n- R. v+ t9 P, I: M& h
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]9 \' T! g3 C; F0 j$ y$ g9 g% A y$ Y
Durable complete molecular remission of chronic myeloid leukemia following
m8 f5 `: j+ xdasatinib cessation, despite adverse disease features.
$ P; |7 T4 c( ARoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
7 I5 X& ]7 e4 N: e" QSource' D8 ^8 O1 G/ g/ K
Adelaide, Australia;
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Abstract% t# W) j4 t" v
Patients with chronic myeloid leukemia, treated with imatinib, who have a5 m0 m; U ~# P0 e- g
durable complete molecular response might remain in CMR after stopping
, s. a& I5 U" z% ptreatment. Previous reports of patients stopping treatment in complete molecular
' U5 N! H" P& T" E5 I- dresponse have included only patients with a good response to imatinib. We
) c' B j t0 idescribe three patients with stable complete molecular response on dasatinib! z5 P1 N7 H& }+ F8 _# u2 }( g
treatment following imatinib failure. Two of the three patients remain in
* A& `0 e" X# u! K9 g3 i, Zcomplete molecular response more than 12 months after stopping dasatinib. In
0 |9 k7 f' s: P9 C7 @$ Uthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to0 z* r, }/ n6 V& P
show that the leukemic clone remains detectable, as we have previously shown in
8 S( {- S. j# m$ zimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
c; V; P; c) xthe emergence of clonal T cell populations, were observed both in one patient
# n% U) B. C5 b+ ]) o6 \' Twho relapsed and in one patient in remission. Our results suggest that the1 ^" _, |& B5 f4 Z: R
characteristics of complete molecular response on dasatinib treatment may be$ ?' Y& C& v4 Q
similar to that achieved with imatinib, at least in patients with adverse
. L% Z: \( i% s. ]: x' l% }disease features.
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显身卡
