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。
% \$ S& \1 {! z5 R& a& {: C 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。) U. o- ^- P" g9 S' x
- D7 W9 H7 E0 @ I7 _. m" F作者:来自澳大利亚8 j& [- @% ?2 V( \# \, x$ P, I
来源:Haematologica. 2011.8.9.
# v1 U% j! V/ |& l1 NDear Group,
3 V8 m9 T/ P1 n; \- D3 h& t6 d. Z3 D3 j: J7 t
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML1 g1 D" e# a* S- T' K5 {
therapies. Here is a report from Australia on 3 patients who went off Sprycel) |- V1 Q K# z8 M! ?) `
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients5 g' K$ x& i H( U6 |
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel0 y5 x |, O+ ~
does spike up the immune system so I hope more reports come out on this issue.5 n: K2 ?* n# `: j7 v6 G
* D0 L$ a4 y6 [1 p/ Q
The remarkable news about Sprycel cessation is that all 3 patients had failed
- @& t/ h, J* @7 p6 _/ ?Gleevec and Sprycel was their second TKI so they had resistant disease. This is, m$ }: ]9 _6 T
different from the stopping Gleevec trial in France which only targets patients
+ e+ L7 V7 y$ gwho have done well on Gleevec.3 y, ~9 u7 O- H1 A. g; q
* f2 h3 `2 g7 b6 k+ {0 r9 EHopefully, the doctors will report on a larger study and long-term to see if the8 t9 `! q4 _. g" ]# G+ W
response off Sprycel is sustained.! l c0 X; V" _5 E
9 w I2 z; c- v( k
Best Wishes,' F$ d% H7 A X) @! s+ u
Anjana
$ ?7 A& ?8 B! g! c* y/ v- B8 a( b+ O7 _* `4 }3 w
6 r% Y; X2 r( w# c
: Q6 F4 T2 n6 j) V- V/ KHaematologica. 2011 Aug 9. [Epub ahead of print]3 D+ v+ g0 c7 B
Durable complete molecular remission of chronic myeloid leukemia following
6 ]; c) |$ b, n: H4 l' H, \5 e* |dasatinib cessation, despite adverse disease features.* R8 ?7 y( D. p+ T9 ?+ X. c
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
1 M1 N) u: f9 u: P- [Source& H" U8 x, a$ w' N: j& k( A
Adelaide, Australia;
, k4 K2 |, p L4 o: }+ ~/ V5 L" u6 N* L
Abstract
: N% S+ [; t' [Patients with chronic myeloid leukemia, treated with imatinib, who have a! B: e0 T1 Q4 q
durable complete molecular response might remain in CMR after stopping
- n/ D0 B' E! |- E2 C% w0 Wtreatment. Previous reports of patients stopping treatment in complete molecular
- B0 I* x+ H4 I! `9 N7 b$ |response have included only patients with a good response to imatinib. We4 r+ H3 l6 l. I) b f: {3 ~
describe three patients with stable complete molecular response on dasatinib9 P# Q2 k' }: s: s
treatment following imatinib failure. Two of the three patients remain in
2 n% Z" k! h% Q, { h3 Fcomplete molecular response more than 12 months after stopping dasatinib. In
6 M% f7 K; w0 R" l4 Y, |3 ythese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
! A3 p6 Y h; |: K6 X" P1 Hshow that the leukemic clone remains detectable, as we have previously shown in
+ J) Q! y4 q; u% D D8 V+ Q( Bimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
5 o: I/ [2 l( Y# T" S {+ mthe emergence of clonal T cell populations, were observed both in one patient- E; ]# [7 N% c" T9 Z7 i
who relapsed and in one patient in remission. Our results suggest that the
5 v8 ~3 V4 n3 q$ Rcharacteristics of complete molecular response on dasatinib treatment may be
# J9 L# C7 L; {. E1 l2 G$ |0 Ysimilar to that achieved with imatinib, at least in patients with adverse8 L: S5 X' G& H8 e/ Y7 Y) A& N/ u
disease features.
. G- ]; n! a& E1 k7 a* h |