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。0 d, `0 X1 c. ]6 p
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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. g! s: z, R: c7 Z/ P. @# L! c作者:来自澳大利亚
5 Q/ e! c# B. p来源:Haematologica. 2011.8.9.: d2 ^3 t/ [1 J: y2 r
Dear Group,* Y& ?: Z! L& z7 |$ q$ j( u
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML0 w5 z' A2 A* A g
therapies. Here is a report from Australia on 3 patients who went off Sprycel7 ~* A6 t2 x% [9 K* C- J. s# ~7 w
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients/ Z) T# B) A' b. V( s
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
. `, W7 i# g; idoes spike up the immune system so I hope more reports come out on this issue.
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: y4 t0 a4 D: c3 H# fThe remarkable news about Sprycel cessation is that all 3 patients had failed
8 L% `0 ~5 ?4 fGleevec and Sprycel was their second TKI so they had resistant disease. This is6 K) r; L/ \( ^" {
different from the stopping Gleevec trial in France which only targets patients
. I* \6 y- m6 ^6 Z9 s/ @who have done well on Gleevec.# ^3 v0 B* U1 j5 p
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Hopefully, the doctors will report on a larger study and long-term to see if the
' r! a& K* Z g8 ?4 t1 nresponse off Sprycel is sustained.
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' N" H/ y+ |) Q2 C3 i) gBest Wishes,/ B' h$ D8 s1 A S
Anjana
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0 }: }% {+ {. |% v0 a. J
Haematologica. 2011 Aug 9. [Epub ahead of print]
4 h4 L' V$ C E- x. K' T$ ]Durable complete molecular remission of chronic myeloid leukemia following/ S& z, z& }$ E- T* x
dasatinib cessation, despite adverse disease features.
8 f+ q* X* n' L$ lRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP., G/ x+ g6 K- Z! T% T
Source
! D$ B0 n" ^+ \Adelaide, Australia;9 W( ]: U) C e7 @8 w2 O
# ^7 V7 b( D$ {Abstract. x H' p) f+ }. h4 S9 J0 y
Patients with chronic myeloid leukemia, treated with imatinib, who have a+ o$ n z6 ?% _! |: _$ u
durable complete molecular response might remain in CMR after stopping
& P% H7 {# W w, r6 F" M$ T: K6 ztreatment. Previous reports of patients stopping treatment in complete molecular
& |6 {2 L! s1 d; R8 o! o+ Mresponse have included only patients with a good response to imatinib. We
) G; J5 n8 @4 o1 Zdescribe three patients with stable complete molecular response on dasatinib
( x* f! \( a0 {3 d# Btreatment following imatinib failure. Two of the three patients remain in
# J) m; n9 o8 A0 c+ @* M$ Ncomplete molecular response more than 12 months after stopping dasatinib. In
2 O6 O. r* M( dthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to* c0 C0 c) O3 q3 R
show that the leukemic clone remains detectable, as we have previously shown in
2 R) c( R+ |) }# i/ Rimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
. @) v0 u/ v, @* r' |" A; Tthe emergence of clonal T cell populations, were observed both in one patient0 p, @3 K1 q3 t
who relapsed and in one patient in remission. Our results suggest that the9 L" `& g/ l; I! ]# J2 X6 [
characteristics of complete molecular response on dasatinib treatment may be0 M0 @$ j# J! C( ^
similar to that achieved with imatinib, at least in patients with adverse
& C7 V8 J: b: A; W# Rdisease features.
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