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。
" L( p7 ]; N! _1 s 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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* m) J- a5 j. I作者:来自澳大利亚3 {: }8 e# v1 a, |3 O) y9 d! [5 E
来源:Haematologica. 2011.8.9.) }2 b, n6 b; k& a7 j
Dear Group,+ h1 l( ^! o! S8 M. z- `
9 ]# f5 E' m# `; h/ ZSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
# l' G/ X- t+ X9 m* Ztherapies. Here is a report from Australia on 3 patients who went off Sprycel& f% m( q9 i2 r! {$ X! u8 I
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients4 } R$ ^& m% }4 R: J3 x
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
+ }5 B; V+ {, U4 o2 pdoes spike up the immune system so I hope more reports come out on this issue.
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, r% X( P% T4 D+ f- sThe remarkable news about Sprycel cessation is that all 3 patients had failed
+ C9 d' ~# `, uGleevec and Sprycel was their second TKI so they had resistant disease. This is; l# F& }3 L; u5 P3 j' U
different from the stopping Gleevec trial in France which only targets patients$ n* `# X7 ^: G
who have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the9 i4 d9 l7 N/ \( N7 C
response off Sprycel is sustained.
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( f+ P2 x0 O& H* `7 w) i3 ?2 iBest Wishes,4 V/ D& X3 o. \1 V: ~* S7 K
Anjana, `+ O! Y2 t# l0 \ A: l Q) ?
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( \9 B( |( f, M' RHaematologica. 2011 Aug 9. [Epub ahead of print]9 q% k1 d2 \4 C& c
Durable complete molecular remission of chronic myeloid leukemia following
: ^2 l. w7 X" a+ M8 P/ Pdasatinib cessation, despite adverse disease features.
. G0 I) C$ a: i YRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.. `3 I& I/ `: s. a6 w' b6 `4 D
Source/ t% E5 s, b, {% U* F3 h
Adelaide, Australia;) B' l8 I8 B: o- l4 w
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Abstract
4 r ^ L7 N Q8 y3 x GPatients with chronic myeloid leukemia, treated with imatinib, who have a$ s, [' a9 }3 ? ~
durable complete molecular response might remain in CMR after stopping* b! e7 o5 g5 {- c# ?# z
treatment. Previous reports of patients stopping treatment in complete molecular
, v3 a) D; e7 `7 ]( dresponse have included only patients with a good response to imatinib. We, L2 s' h/ E& y( c1 L' }( A
describe three patients with stable complete molecular response on dasatinib5 r3 T! S3 J. D2 B! \5 k$ x S
treatment following imatinib failure. Two of the three patients remain in
8 y$ g" W9 i- v0 w7 \complete molecular response more than 12 months after stopping dasatinib. In
. e8 b3 n# q! tthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to( T3 Z: ?- `/ C- ]- ~ Y. h
show that the leukemic clone remains detectable, as we have previously shown in$ A& |/ h) } y$ i- C
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
& `+ w" _& c0 _$ M6 Pthe emergence of clonal T cell populations, were observed both in one patient8 j; k2 q8 O' g- a
who relapsed and in one patient in remission. Our results suggest that the
, I0 x1 c) i0 ncharacteristics of complete molecular response on dasatinib treatment may be1 U, ~. L* R( k* r. } M
similar to that achieved with imatinib, at least in patients with adverse
5 H3 P* U; v7 |" Idisease features.2 G: U8 b1 a, V
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