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。
* I u f R" w. l4 D& t- p; b* S: q 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。4 i) v; S" y8 d% N
- l0 F/ ~0 f( }! R, H作者:来自澳大利亚& K5 X5 m2 o- x6 f8 }
来源:Haematologica. 2011.8.9.
& h& ~- `7 b8 I J( I7 ^& H' HDear Group,
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5 p1 A( h m( P8 L) d/ P' G: SSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML& ]* V+ p N# |/ w" b
therapies. Here is a report from Australia on 3 patients who went off Sprycel
6 \; m2 c; D, N/ {- Qafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients! F$ x% ~2 r: L
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel0 d1 B- P6 ^$ I+ j1 j
does spike up the immune system so I hope more reports come out on this issue.
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$ z" j; \+ _9 q0 I, o8 s: g, pThe remarkable news about Sprycel cessation is that all 3 patients had failed5 I$ A, S2 R, S& z; a7 U3 c
Gleevec and Sprycel was their second TKI so they had resistant disease. This is: ?; g5 D0 Z) D; _
different from the stopping Gleevec trial in France which only targets patients5 _1 X( }" [* H2 @. s, h
who have done well on Gleevec.' ~' `2 c8 t) X3 T* R
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Hopefully, the doctors will report on a larger study and long-term to see if the- h# J8 L h; V3 z2 y* A
response off Sprycel is sustained.
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+ h$ V% P4 W$ c! c7 J4 xBest Wishes,
& ^+ o1 Q3 A. tAnjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]# J% c, w a) S/ u* F0 ^% E
Durable complete molecular remission of chronic myeloid leukemia following4 _; C. |4 ]. l+ S, ?0 K+ w- I
dasatinib cessation, despite adverse disease features./ `# J& r) I9 m* H
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.1 W+ Z! E; Z) a2 K. v# w
Source: [! K" v9 p* Y9 w4 K5 m( m
Adelaide, Australia;
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Abstract
$ q& O. ?. D7 |Patients with chronic myeloid leukemia, treated with imatinib, who have a
* k5 F6 |6 P* n. z- n- e1 rdurable complete molecular response might remain in CMR after stopping
+ n5 J2 {) k7 d8 H% Etreatment. Previous reports of patients stopping treatment in complete molecular
3 `- y) X9 m* {: B( d* f- oresponse have included only patients with a good response to imatinib. We
Q. i5 w6 j! M% cdescribe three patients with stable complete molecular response on dasatinib
0 x- W8 D3 n4 r3 s6 Ktreatment following imatinib failure. Two of the three patients remain in+ G- m& V P% W& y) `/ l
complete molecular response more than 12 months after stopping dasatinib. In
9 R% x' r4 N) u$ o; Qthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
& C% `; w" n; p v! e$ F3 N8 p2 Vshow that the leukemic clone remains detectable, as we have previously shown in4 R4 n4 b! \, F
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as8 x, j( s1 `2 O# g1 l; b+ ^
the emergence of clonal T cell populations, were observed both in one patient
0 f) h A9 m( ?who relapsed and in one patient in remission. Our results suggest that the6 V- I6 t( G" p& T: ^ \
characteristics of complete molecular response on dasatinib treatment may be
# _. D$ g `- p; u+ asimilar to that achieved with imatinib, at least in patients with adverse
$ u P8 F6 Z3 {5 ddisease features.; ~0 V3 j- {/ x+ Y$ h' f
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