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。
3 o6 j) g' Q9 m+ O+ i) T" X1 r( T+ c' S
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
9 j% F0 ]& l& G  I/ H- \& ]; T7 ]+ xtherapies. Here is a report from Australia on 3 patients who went off Sprycel
" E$ D" C/ a1 U( n: \- q  Safter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
8 t6 h6 V- V! `+ J$ i& R- N1 tremain 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.

6 u1 |' y3 S0 s/ D9 WThe remarkable news about Sprycel cessation is that all 3 patients had failed
5 f& E6 t; ]/ f) QGleevec and Sprycel was their second TKI so they had resistant disease. This is
1 q; X' `# {' ^/ m$ D9 U% mdifferent from the stopping Gleevec trial in France which only targets patients
7 j/ ~% F7 n$ c0 l! v8 o( iwho have done well on Gleevec.

Hopefully, the doctors will report on a larger study and long-term to see if the
8 C9 t* V* h; Q: W' bresponse off Sprycel is sustained.
. K' F9 J/ B/ H+ k3 t
Best Wishes,
Anjana
* I6 a% s+ z3 u
% p3 l# u( t' i

Haematologica. 2011 Aug 9. [Epub ahead of print]
4 [2 p& L- ?" L2 M& {5 T2 UDurable complete molecular remission of chronic myeloid leukemia following
5 Y$ g. \) T( i4 S% `# `+ sdasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
Adelaide, Australia;

Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
1 s& N2 W  [* w4 J# `3 J9 w5 zdurable complete molecular response might remain in CMR after stopping
. y/ m9 e+ c! L; x0 Q  ~/ t4 p9 @, ptreatment. Previous reports of patients stopping treatment in complete molecular
: a/ F8 S1 u$ ^: c# u" {response have included only patients with a good response to imatinib. We
* ?! s4 ~5 U, w) y6 R( j+ Bdescribe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
. o" s9 U# C( x: M" q  ?$ f8 T. wcomplete molecular response more than 12 months after stopping dasatinib. In
& }  l2 E+ h# U$ ithese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
9 U! N) D+ A$ }: K. s5 gshow that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the 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
7 R* P- |; F% `/ ncharacteristics of complete molecular response on dasatinib treatment may be
3 a# x8 P. y( gsimilar to that achieved with imatinib, at least in patients with adverse
9 s$ H  @3 H( {$ Xdisease features.
) g% L4 ^* g$ G3 Z% L4 x

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。
* p# n4 H9 x6 A5 {1 l    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。
  j. `2 \3 ~, L    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。
4 A3 ?& a4 V7 s6 \
作者：来自法国STIM试验
* @* V7 ?' l3 o6 s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