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。
8 @$ X& Z# _. [5 `7 Q' v* R. N; j 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2 `) s$ d- B" r3 \) E
来源:Haematologica. 2011.8.9.5 T/ I0 F3 ~/ Z/ b5 K+ ?' a
Dear Group,
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$ ~, ?9 b3 }3 ^. y; zSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML: k& ~; w# ]5 o- A" d5 U
therapies. Here is a report from Australia on 3 patients who went off Sprycel
# n4 ]. r: y9 p$ t9 Z- w, xafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients8 \, h" \ r* Z3 g% X; D( _0 s8 ?- G
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel8 e7 q% O* i4 B" P1 G6 j" i. i* Y
does 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 failed2 s4 X# _) ]: l3 v2 z
Gleevec and Sprycel was their second TKI so they had resistant disease. This is1 U1 y# L7 s; w& v
different from the stopping Gleevec trial in France which only targets patients
) g, a! R- H7 |+ l1 l awho have done well on Gleevec., `( M, Z! e, u. [2 @/ ]3 M0 I
4 P5 i) I: z8 THopefully, the doctors will report on a larger study and long-term to see if the
|/ ^9 F0 y- ^! B# fresponse off Sprycel is sustained.
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Best Wishes,! J \' _- i- S: W9 C$ {! \
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print] j, b9 K: P B
Durable complete molecular remission of chronic myeloid leukemia following
/ h- s a: T3 X5 ]5 q, Edasatinib cessation, despite adverse disease features.
' D4 y, \+ C3 w; FRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
& T9 T/ [1 e0 R. j* H# Y% L/ w# C" {Source& a5 Y" Z, u7 X; G/ K! V* \: Y
Adelaide, Australia;
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Abstract
1 A# R: }" }; S# k% T; ^8 wPatients with chronic myeloid leukemia, treated with imatinib, who have a8 {, H P* q& }5 c$ z; x6 E
durable complete molecular response might remain in CMR after stopping" E4 K. Z) _: C% X1 `& s8 g
treatment. Previous reports of patients stopping treatment in complete molecular
$ Y( G0 P- ?/ f Fresponse have included only patients with a good response to imatinib. We
& r( ?# T9 E4 i L. R5 J3 {describe three patients with stable complete molecular response on dasatinib3 b% u6 U+ ]5 ^# ~1 s
treatment following imatinib failure. Two of the three patients remain in' H4 T$ { F+ m% n+ z2 a% Y
complete molecular response more than 12 months after stopping dasatinib. In
$ b" E5 N3 p0 ~0 zthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to+ @& A1 G: S) ^0 c3 s8 y
show that the leukemic clone remains detectable, as we have previously shown in) t) E; K! K! b7 ~& v0 e
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as9 v+ B' _" {: B2 q
the emergence of clonal T cell populations, were observed both in one patient; P1 M% M! x L: M4 ]2 L
who relapsed and in one patient in remission. Our results suggest that the
1 z# G+ H$ m3 T+ \4 }3 u5 Wcharacteristics of complete molecular response on dasatinib treatment may be
% H2 n! B% @/ z' t" s, |3 G2 Dsimilar to that achieved with imatinib, at least in patients with adverse" F7 I1 R0 H, e: i6 x; w
disease features.; E' C0 ]- ?! q3 ]0 U! k9 u
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