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。
" q) B2 z' |5 z' O. C  s$ L$ K4 ?    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。

作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
' Q2 u* Z% t/ i/ W" {1 KDear Group,

  q5 A* t7 g3 nSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
0 m8 x4 N, R5 P1 @5 {- O% xtherapies. Here is a report from Australia on 3 patients who went off Sprycel
# F; {8 A1 s% k% \" A3 H* Y% mafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
- E8 `5 u6 w0 E, f# p. rdoes spike up the immune system so I hope more reports come out on this issue.
+ ?+ C& c: u, m
2 O; F$ a* {4 M, SThe remarkable news about Sprycel cessation is that all 3 patients had failed
: a& V) p/ l! R1 ]0 }9 n6 g" n0 YGleevec 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
+ `0 v! P8 O, L5 g1 H7 lwho have done well on Gleevec.

Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

2 @( G1 x! K# n- ^" N" Q8 i* lBest Wishes,
Anjana


2 Z0 Z2 ~; H1 p+ a3 g& C
Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
( p* c  J5 q. N# t  E& E! l! j  B+ [dasatinib cessation, despite adverse disease features.
% ?  _* W( a6 `; E# y; PRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
  t7 g! A5 r: p+ j* q- TSource
! D0 t, d* a' n$ ?1 p: n* |Adelaide, Australia;
( }* r. r! c4 l5 B3 ^- A( D2 }
Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
5 A5 r7 `, a- F2 [) A7 Etreatment. Previous reports of patients stopping treatment in complete molecular
  ]0 E- v- k$ v8 a3 \- X& \: W7 B4 Jresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
+ b5 ?1 D) ~: q6 H9 u" ztreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
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
, q: m) ]8 [: J+ _( A9 V9 Uwho relapsed and in one patient in remission. Our results suggest that the
characteristics of complete molecular response on dasatinib treatment may be
1 u; M/ B% g& T! n- m) ]3 Ksimilar to that achieved with imatinib, at least in patients with adverse
2 b- z0 v5 T, @1 idisease 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。
    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。
# X) I/ S" i* I4 w6 V    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。

) u1 |3 a# }; k  N# G0 X& x作者：来自法国STIM试验
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