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。0 F% ]' i9 \/ 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。
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$ G6 V" M" h' t4 W1 Q作者：来自澳大利亚( m0 ~) o! m. V2 T/ }- H) ? N- D0 T* W
来源：Haematologica. 2011.8.9.$ b1 A# m; q3 D" K3 r+ v
Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
1 J5 O6 i* A" S. P# [8 Vtherapies. Here is a report from Australia on 3 patients who went off Sprycel
3 T' \6 t: y+ V9 yafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
/ U- r+ L I. r0 rremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel/ ]1 h6 C1 V; T/ f
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- z/ V3 W+ G; v6 K6 d" h7 S A# D7 x
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
" b5 p- B' c# N. T' \( ], y$ Wdifferent from the stopping Gleevec trial in France which only targets patients
* {3 _( W9 I ]5 S4 Hwho have done well on Gleevec.# l$ J; b7 ^ y/ h7 T: f4 C
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Hopefully, the doctors will report on a larger study and long-term to see if the7 w* {* V) C' B# r8 M4 x' ]
response off Sprycel is sustained., J2 v% s8 _" ~$ l% F; V6 S4 @
# |- \$ I/ [$ ]( ?! X2 Y0 [
Best Wishes,' B4 R8 p8 f! F8 `/ Y/ g% g0 s$ x% o
Anjana
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) T* N0 \& ~+ W6 { F4 sHaematologica. 2011 Aug 9. [Epub ahead of print]6 f) G X7 p( L* `0 X2 U, [
Durable complete molecular remission of chronic myeloid leukemia following
9 L; e* }! N# X3 g- Fdasatinib cessation, despite adverse disease features.
$ t7 n( `1 D- p9 `Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.% c9 j! M* Y2 H2 O! K0 Z+ Y2 O4 h
Source
1 B* Y- S4 E0 b/ T( J$ ~Adelaide, Australia;1 Z {* q/ j, j: Q3 z
x# ^1 o6 ]- D( d% Y/ m. X9 n: E8 _Abstract
& g$ ~( f% s7 e' JPatients with chronic myeloid leukemia, treated with imatinib, who have a$ y, C: l) ~2 B( t9 W
durable complete molecular response might remain in CMR after stopping n" y# g$ H1 g# v1 p$ h
treatment. Previous reports of patients stopping treatment in complete molecular
2 y) N, \. |/ `5 rresponse have included only patients with a good response to imatinib. We/ K& g; G( f# {1 x
describe three patients with stable complete molecular response on dasatinib
* p' m- J# U0 y0 r: W7 f! p/ ftreatment following imatinib failure. Two of the three patients remain in
6 _" I, T% T2 o {complete molecular response more than 12 months after stopping dasatinib. In
! M3 D3 W, I, Cthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
: u" o' F9 N+ b) b4 u9 j$ Vshow that the leukemic clone remains detectable, as we have previously shown in; J) O) J; @4 e* K% @+ o4 _
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
8 [- u( P/ |5 M2 U/ P$ Kthe emergence of clonal T cell populations, were observed both in one patient
) J6 h# D9 v9 zwho relapsed and in one patient in remission. Our results suggest that the
% [# ~6 K( H" @: `3 o' E1 Ocharacteristics of complete molecular response on dasatinib treatment may be
* D) ]$ K& s: m* ] p0 B7 wsimilar to that achieved with imatinib, at least in patients with adverse
2 o! L" M. g- O% {disease features./ z Z# t9 ~/ t1 G% w* z/ R
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