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。
. C* z( \6 n9 k8 Q# G! U 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+ k" i, s, P \2 `2 J) U5 b
来源:Haematologica. 2011.8.9.! G1 J" f7 a, E9 v s4 S8 j0 P
Dear Group,) B+ v4 B; t# ~/ H K
9 d, y. E' R( `; H8 K+ Q( h8 RSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML+ ?9 I6 H2 A( Z/ R/ s9 e
therapies. Here is a report from Australia on 3 patients who went off Sprycel8 h$ `; e" r2 {
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients8 H) Z: |- C1 Y6 |- } b
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel( u4 d+ n5 W. E5 G
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 failed
0 x9 s! [& u( pGleevec and Sprycel was their second TKI so they had resistant disease. This is
4 S( k" H* V" Ydifferent from the stopping Gleevec trial in France which only targets patients. G7 z, x( Q8 Y$ [# p2 J% ^0 I ]- k
who have done well on Gleevec.
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6 B. f# d9 q) B4 W+ NHopefully, the doctors will report on a larger study and long-term to see if the
. i X# \ k- M( C; p: I3 Kresponse off Sprycel is sustained./ J1 T. B& J; Q3 w
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Best Wishes,
: I4 l1 t) I1 ?0 g+ _6 [6 O6 V2 OAnjana
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1 P+ {9 ?; v9 m/ F/ ?Haematologica. 2011 Aug 9. [Epub ahead of print]" S0 ?( T9 E# D$ q6 D# U0 j
Durable complete molecular remission of chronic myeloid leukemia following
- l/ s# ?: q' B& y5 rdasatinib cessation, despite adverse disease features.! A/ s" d5 F3 b \
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.0 B: p9 G1 u% @, ~
Source
1 c( y0 {; R( ~3 d# X' WAdelaide, Australia;/ Q9 H6 V3 s- f2 S
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Abstract
8 `* }1 {# M7 t6 CPatients with chronic myeloid leukemia, treated with imatinib, who have a7 L1 [! Z7 m6 ]/ B/ p; d3 W( ]" `
durable complete molecular response might remain in CMR after stopping: R. a# f5 \2 {% B8 }& U
treatment. Previous reports of patients stopping treatment in complete molecular# b: A, d2 e0 g# J( k0 V9 x6 p
response have included only patients with a good response to imatinib. We0 M$ s! }/ J- q/ q2 p% b: x6 L
describe three patients with stable complete molecular response on dasatinib
! q3 l# k( I0 Q# w2 S% [2 T. k' qtreatment following imatinib failure. Two of the three patients remain in) X) m$ P% d4 ~4 ?5 @! L/ E/ V( [
complete molecular response more than 12 months after stopping dasatinib. In
; j1 b* G0 s- d, qthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
) L% o+ p2 n+ p8 |# N4 o* ushow that the leukemic clone remains detectable, as we have previously shown in: R. j3 e3 D% }$ k8 Y( l
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as' S0 |6 K" y( n- J, Z: J4 {3 g7 x: {" d
the emergence of clonal T cell populations, were observed both in one patient! v; [4 c1 R; n/ o' D0 o6 d9 [
who relapsed and in one patient in remission. Our results suggest that the& H/ l5 F' M( u/ v9 }% `1 [
characteristics of complete molecular response on dasatinib treatment may be
& S6 b/ ~3 n8 B7 S" T9 Asimilar to that achieved with imatinib, at least in patients with adverse- e8 H D5 B U! l' j( u
disease features.6 w$ e) j& r) W+ p2 @( N2 N
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