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。4 f& Y; u- M2 n1 o# a5 D3 Z
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 L% w6 {0 {# V0 c) M$ B; s- ?
来源:Haematologica. 2011.8.9.
* u3 V! _2 w; ~ T4 E* n6 }Dear Group,
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3 Y. t7 j8 Y% Y. PSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML. A! m9 ?3 v6 H1 e
therapies. Here is a report from Australia on 3 patients who went off Sprycel- @4 }. ]0 I; z% T
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
; i8 A3 A" V' Y, aremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel. R Q! W+ @5 \0 C; @4 x
does spike up the immune system so I hope more reports come out on this issue.4 r3 o% L3 Q& p1 h2 _
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The remarkable news about Sprycel cessation is that all 3 patients had failed
4 N7 c$ F! y6 v- S% [0 PGleevec and Sprycel was their second TKI so they had resistant disease. This is
9 j6 d$ X* I& k: R3 Vdifferent from the stopping Gleevec trial in France which only targets patients8 g# |/ f; J" }
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 the
4 j- f6 Q6 O! ^8 D' L2 L: ?. Sresponse off Sprycel is sustained.) x% m- p/ u. W3 i
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Best Wishes,' M3 G4 u! y* `+ s" ?: C: B
Anjana- X, y# b$ Q z4 ~/ W9 O9 e
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Haematologica. 2011 Aug 9. [Epub ahead of print]4 T! l/ S3 S; r+ N- {7 e" t
Durable complete molecular remission of chronic myeloid leukemia following
1 c- K7 `: X5 M8 Z" T _dasatinib cessation, despite adverse disease features.% k3 l% o3 y- }# T. P$ k
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.! w$ T5 x0 G P1 v7 }+ O/ ?
Source
' x6 f0 ]! i) OAdelaide, Australia;# q! C: x" Y2 }$ R
* ^. `. W. P, {& U7 s5 ^0 J# tAbstract
. l9 p' B) V- XPatients with chronic myeloid leukemia, treated with imatinib, who have a( j# ~& F1 ~5 \) e
durable complete molecular response might remain in CMR after stopping
0 d5 c* ~3 g4 L) o6 U+ P- E5 Mtreatment. Previous reports of patients stopping treatment in complete molecular2 ?) {9 z& V' G2 N' Z0 z8 y
response have included only patients with a good response to imatinib. We5 F% m- @! ~2 ~& `0 k
describe three patients with stable complete molecular response on dasatinib
+ \) r6 \% W# itreatment following imatinib failure. Two of the three patients remain in0 l4 R( l) e9 [5 w6 R( O
complete molecular response more than 12 months after stopping dasatinib. In
- L( B, [! _4 z! h3 U, R( X- Rthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to3 d6 j" J! J4 o" n
show that the leukemic clone remains detectable, as we have previously shown in
, v" c0 h5 J' T# \, e0 himatinib-treated patients. Dasatinib-associated immunological phenomena, such as1 f% y" ~# g; _+ \( c; t# }5 U& }
the emergence of clonal T cell populations, were observed both in one patient% Y# T* G2 U- a5 o! h
who relapsed and in one patient in remission. Our results suggest that the% _% t- i* @3 @, A Z9 j
characteristics of complete molecular response on dasatinib treatment may be
& q8 J( u/ e" Usimilar to that achieved with imatinib, at least in patients with adverse; o d, @, @ } w: v: K: |# H
disease features.
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