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 B; W( a+ H; V: ]" o
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。! m' W2 A( f4 l; a7 E/ }
6 F0 X5 ?. f. e M5 a. v作者：来自澳大利亚
& |5 X9 K8 b. b* S来源：Haematologica. 2011.8.9.
' z- i Z3 F& ]0 E/ R0 _' PDear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML+ g6 s+ J6 Z% s' ~7 z
therapies. Here is a report from Australia on 3 patients who went off Sprycel( z5 Y' P {, |2 m% ~" A1 r) {% _
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
+ O- V, G* A) S3 a1 J! q4 tremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel2 \) x" p! n8 C- ]+ p4 o. O
does spike up the immune system so I hope more reports come out on this issue.+ \# q. ]& w$ o5 ^
% j/ X7 P% Q" T: f) ?: dThe remarkable news about Sprycel cessation is that all 3 patients had failed: f2 U; z9 S( O: ?/ I
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
& w% a) O) `: _6 u' J7 E7 q0 e( N% ]different from the stopping Gleevec trial in France which only targets patients
* |/ ~' A2 \: `4 h; W" Mwho have done well on Gleevec." e' j! r7 p& L' i
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Hopefully, the doctors will report on a larger study and long-term to see if the
% x6 D7 D; ^/ Q, f; e" gresponse off Sprycel is sustained.' h. H! d/ @ m- O" R7 b" d% B
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Best Wishes,
7 d3 D0 f& L ]Anjana
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# z( P6 t8 @$ i$ I7 _7 r. e: }) o/ Y
Haematologica. 2011 Aug 9. [Epub ahead of print]9 T/ s" i) K& |
Durable complete molecular remission of chronic myeloid leukemia following
( i. _( k+ g1 U3 j) Rdasatinib cessation, despite adverse disease features.
3 Q( @, Y! I1 kRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.) `' B# Q0 Z$ J i
Source
# U- z# }/ ^% {3 B& h BAdelaide, Australia;* I2 g) i9 e* y, J$ d' {1 w* [* _
, S5 v. P/ Q6 ^ R7 i3 a3 M- }Abstract1 j. `. }+ l& A6 b* k/ G
Patients with chronic myeloid leukemia, treated with imatinib, who have a, H: B! Z! j3 q
durable complete molecular response might remain in CMR after stopping2 W- d' q8 P* V' g' q7 n# ]
treatment. Previous reports of patients stopping treatment in complete molecular
# Y' I; M6 H# D1 Vresponse have included only patients with a good response to imatinib. We
5 I* O& X- ]! Z* R+ [! e/ W5 _describe three patients with stable complete molecular response on dasatinib1 _& D+ A6 _. k! ^. [' h
treatment following imatinib failure. Two of the three patients remain in
3 t' n( b) u$ Z6 W3 v3 I0 N5 Rcomplete molecular response more than 12 months after stopping dasatinib. In
" F4 M( j0 \5 | b% ?# o5 ~these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to W8 w6 v3 I3 K' u% `
show that the leukemic clone remains detectable, as we have previously shown in/ T" d( [! @" g$ m) D
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as2 _/ |& b# G* C9 A- `: i
the emergence of clonal T cell populations, were observed both in one patient" V& R- n1 F: C3 Q
who relapsed and in one patient in remission. Our results suggest that the
5 ]' I7 P1 t3 z h6 `$ o5 Tcharacteristics of complete molecular response on dasatinib treatment may be
0 y5 z* O5 m# @similar to that achieved with imatinib, at least in patients with adverse! a$ Z6 d/ A# n
disease features.$ g- v' o& ~; [# D$ g8 ~5 I: S0 k1 {
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