关于停药的相关内容

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。
    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。

0 m) P& p3 Y7 \! n; T作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,

Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. Here is a report from Australia on 3 patients who went off Sprycel
" U- y3 U! L1 b; ~. {0 hafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
does spike up the immune system so I hope more reports come out on this issue.
0 }/ O" ^) B: D" p: s
$ d5 v' z# P' e- v0 uThe remarkable news about Sprycel cessation is that all 3 patients had failed
! E( W  m+ R, E1 E/ Z' R! d% eGleevec and Sprycel was their second TKI so they had resistant disease. This is
' |1 l) {4 q/ G; z. C+ W6 P4 U3 K# xdifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
0 X* P9 J* |4 y% R5 S3 Z
" N" A. x) G) j7 sHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
- n4 r$ o" y' z# u. K
( n4 @" Y: ^+ b% t  D$ PBest Wishes,
Anjana
, a" l1 I  W$ G7 Z" e9 s5 Q

) a: h4 G$ U1 W* o
Haematologica. 2011 Aug 9. [Epub ahead of print]
2 k$ s1 O: _& T% M+ SDurable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
, x# o8 X5 x# p! }Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
" V  Z$ j" Z. \: R( g( ]Adelaide, Australia;

Abstract
, ^5 M* d' Q+ w3 ^Patients with chronic myeloid leukemia, treated with imatinib, who have a
& |; J8 s+ U! @$ u4 ^) _durable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
3 C9 x$ X+ t2 F1 Yresponse have included only patients with a good response to imatinib. We
! A" ~& e" g& i% f2 u% C( e3 kdescribe three patients with stable complete molecular response on dasatinib
/ {+ k4 C/ p) D  r8 Xtreatment following imatinib failure. Two of the three patients remain in
' X# ~' C) K- ~7 I  Ecomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
show that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
( C, b" a, j3 k- c& p: bthe emergence of clonal T cell populations, were observed both in one patient
who relapsed and in one patient in remission. Our results suggest that the
2 \% J# {" h& f# ?; ]characteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
+ d/ l' x4 V2 a: v; Edisease features.
% N! T. v% B& o* y5 i% q# E' A

摘要：（STIM试验为法国的格列卫停药试验。）这个研究中，患者先是取得了CMR（融合基因转阴），然后停用格列卫，而后复发。15名复发患者在重新服药后又一次取得了CMR，他们同意再次停药。
& J: p: G# u) R$ q. c$ E    第一次CMR持续时间为31个月，然后患者停药，复发的中位时间为2.6个月，然后重新服用格列卫，中位时间5.3个月之后取得第二次CMR。保持第二次CMR中位时间19个月之后，患者同意再次停药，这次，15名患者中有5名在停药随访中位时间24个月后仍然保持了CMR，而10名患者在停药中位时间2月后第二次复发。
+ I5 U( X7 r/ ~& p" W: @8 g! D    请注意，这些患者都是在第一次CMR后停药然后又复发的患者。
( i9 c( I0 ~& n0 u0 w0 R' ~  W
: D. Z4 H# t4 x, h8 A作者：来自法国STIM试验
来源：EHA 2011.6.会议摘要

很不错的文章，看来马老师家有考虑停药的想法了啊！祝福！

期盼易或特也能停药，但现在觉得是一个梦想！

这个非常有意义的研究。能吃下来停会再吃，再停，那是天大的好事