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。
    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。

0 s9 A' k2 q# g! q* t& {  y作者：来自澳大利亚
, i, Z! _( |" ~% k6 P; m0 N来源：Haematologica. 2011.8.9.
Dear Group,

Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
4 ?( R5 ^# A* R& m, ytherapies. Here is a report from Australia on 3 patients who went off Sprycel
& ^: A1 f4 F5 |after 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
5 m# }! x2 t: r; E$ |6 g3 _7 Gdoes spike up the immune system so I hope more reports come out on this issue.

The remarkable news about Sprycel cessation is that all 3 patients had failed
$ M: U% a! d. ~2 oGleevec and Sprycel was their second TKI so they had resistant disease. This is
2 p$ V) N3 N/ x! j* V( s1 ydifferent from the stopping Gleevec trial in France which only targets patients
# T9 m( W, ]) L: ]- cwho have done well on Gleevec.
* Q4 x' S" l3 g0 M5 V% _
Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

; H: m) H3 ^5 cBest Wishes,
Anjana
; z7 v1 @6 T" n7 A


Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
) p0 p) w8 I# G: s( adasatinib cessation, despite adverse disease features.
# [: g  v6 x4 Q! Y9 sRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
) l/ X1 O0 N' C/ _Source
% `2 S' w. n# w' f  wAdelaide, Australia;
  M( N( M# I. F+ k
Abstract
) [+ e' [  o8 }9 q1 \3 z2 WPatients with chronic myeloid leukemia, treated with imatinib, who have a
: v" B; X: `( j8 M: ?0 [" Odurable complete molecular response might remain in CMR after stopping
6 T+ q4 X3 m2 p6 T5 p+ I+ _treatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
: L# g* B1 `5 y! J0 n6 {describe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
$ h) |) s! y" M, S- n8 a7 N2 x' Ocomplete 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
- I! L( @) f6 W7 d, l; y( w* ]8 Ethe emergence of clonal T cell populations, were observed both in one patient
8 v4 r+ G: d* d9 Y9 \4 C- Dwho relapsed and in one patient in remission. Our results suggest that the
characteristics of complete molecular response on dasatinib treatment may be
& N7 a8 f5 N" p& o, `' Q5 _similar to that achieved with imatinib, at least in patients with adverse
. y' z: V! R* ]; Rdisease features.
6 v; r' X8 ^* s

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。
- b7 V" ~, t- W* z* X) x/ P    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。
; ?: v; F0 j7 I; M6 l5 O5 z
9 h6 D( [- m; a5 f作者：来自法国STIM试验
! o, `7 c* r& e: o6 `2 M- Z; @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