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。
! M: g( i9 Q( h0 ?& R3 U( W    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。
) g& b  J, E) m0 H
作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,
, S, P5 u3 `( ^; S
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
% E3 n/ x! ^1 z' t, _after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
2 k1 t- ]# {3 J. N) Bremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
does spike up the immune system so I hope more reports come out on this issue.
. S( |" ]0 v) w( i+ j0 ?
/ f9 R$ @. o# N7 G! O; W9 k+ l$ J" |3 ~The remarkable news about Sprycel cessation is that all 3 patients had failed
Gleevec 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
' i, m: \6 J6 T$ p# Twho have done well on Gleevec.

; R9 {1 ]4 b3 A: r# @( k9 z! w$ SHopefully, the doctors will report on a larger study and long-term to see if the
# ~9 P" z+ l9 Z1 h9 x: G% o& _response off Sprycel is sustained.

Best Wishes,
$ i* F/ u, G- r: LAnjana
* N8 X9 U+ [/ f; X' s6 X
, d7 o# _' b, W) G- ^* ~; c1 ^
! a/ c- G6 c, ~3 ^5 U
Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
/ f; y9 Y$ D0 {. D& E( Xdasatinib cessation, despite adverse disease features.
+ G' W: J: _. }8 d# pRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
7 K2 `* N9 D9 Z; Y; ], BAdelaide, Australia;

6 z; U% P# ?! |0 z* H  K4 P" nAbstract
7 W' O3 b- k1 hPatients with chronic myeloid leukemia, treated with imatinib, who have a
( h0 I) J; W: r7 odurable complete molecular response might remain in CMR after stopping
0 n# s; s3 H' N  f+ h' f  p2 {, Btreatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
2 E& I7 v. G; n& _8 f0 cdescribe three patients with stable complete molecular response on dasatinib
6 `0 v5 t1 l( f$ dtreatment following imatinib failure. Two of the three patients remain in
# A, d8 P. i7 a% K7 ^# Ecomplete molecular response more than 12 months after stopping dasatinib. In
4 f" L' h$ u4 I( Kthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
2 [+ f: K& @" [2 @' y' B. r1 g; F' ushow that the leukemic clone remains detectable, as we have previously shown in
* @9 x1 t7 W% x6 V) mimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
' l$ b  H+ _3 othe emergence of clonal T cell populations, were observed both in one patient
# u) I$ U8 r& W( _who relapsed and in one patient in remission. Our results suggest that the
characteristics of complete molecular response on dasatinib treatment may be
! V1 a3 h+ v6 C. Z  @+ T6 @" @similar to that achieved with imatinib, at least in patients with adverse
disease features.
0 c/ S1 [) r+ S5 X' x

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。
% i& K$ z) P9 r  x" k5 G. M    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。
    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
* q" _5 _3 C0 c+ D: a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