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。
/ ?2 ^; }/ u6 g1 U 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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' d, {. [8 D/ q. S8 d6 K7 u作者:来自澳大利亚
9 j; e* l5 T8 w3 Z: ]+ }/ O# |( R来源:Haematologica. 2011.8.9.6 F" |; {5 D) L+ J: t: i& u* G, W
Dear Group,4 W, a6 p3 b& C H- [" \
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
8 C+ {% U* F) k, [' b2 jtherapies. Here is a report from Australia on 3 patients who went off Sprycel
- [( s4 Y: |8 Y% bafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
( s! L2 N5 C6 C& v7 g6 w' L, Fremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel5 b: z5 B( f" J& Q0 Y( X$ x* Q/ ^
does spike up the immune system so I hope more reports come out on this issue.
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- Q6 ~$ B8 ^& q+ p1 ~) t; e4 `: T+ M9 |1 [The remarkable news about Sprycel cessation is that all 3 patients had failed
; N' ], g5 `9 C; |Gleevec and Sprycel was their second TKI so they had resistant disease. This is+ H( s# q. E0 K
different from the stopping Gleevec trial in France which only targets patients
& j9 D, `' S, X# R/ p* p; owho have done well on Gleevec.
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- p2 h* q+ |- ?Hopefully, the doctors will report on a larger study and long-term to see if the
& z" T p/ V* C) F. {- w9 Fresponse off Sprycel is sustained.
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1 Q7 b# p Y3 H- F7 U: Q" S4 Y4 OBest Wishes," E7 i! t* a6 v/ _' o& w8 g1 L
Anjana9 R( f, h- n" g: Y
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Haematologica. 2011 Aug 9. [Epub ahead of print]3 {( c" ~. w6 B5 X/ |, l" \
Durable complete molecular remission of chronic myeloid leukemia following( S! @4 P4 t+ W1 C ?* {" s y
dasatinib cessation, despite adverse disease features.
$ u. ?& r( [, l7 E2 N% t4 BRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.2 G4 ]% _. ?. h& U3 b
Source
5 ]. `2 b6 V5 {% U8 N4 P7 @; xAdelaide, Australia; U0 j1 X2 }9 a# v
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Abstract
3 _. [, c; U- | ]& l' a% Y2 u" B' LPatients with chronic myeloid leukemia, treated with imatinib, who have a
, B) @* E3 t2 r% \' s4 Ndurable complete molecular response might remain in CMR after stopping/ q2 Q( d3 D+ O/ q) z3 q3 R
treatment. Previous reports of patients stopping treatment in complete molecular+ V% \* f, K% b3 X- q9 P
response have included only patients with a good response to imatinib. We4 X7 z) h& ]6 u+ d6 p# x9 g
describe three patients with stable complete molecular response on dasatinib6 K; w# [) Z4 Y8 x. j0 r4 t
treatment following imatinib failure. Two of the three patients remain in" V0 Q1 Y+ a# U4 N4 @/ U
complete molecular response more than 12 months after stopping dasatinib. In- e5 ^0 `. p& I. E ^
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to2 r# b& t+ ]! x2 B
show that the leukemic clone remains detectable, as we have previously shown in( d" n; r3 ~8 c6 w4 n
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
$ X6 e3 H- e q1 _" n2 Kthe emergence of clonal T cell populations, were observed both in one patient
) y) P5 ]* S' N/ @* Twho relapsed and in one patient in remission. Our results suggest that the
9 A. X) r' _9 Y% `characteristics of complete molecular response on dasatinib treatment may be
4 g; ^6 B9 q& v# l- y. e' E' isimilar to that achieved with imatinib, at least in patients with adverse6 D# m- q. U& ~9 y; Z6 V& L& B
disease features.7 ^; ?; \& h- Y/ W6 q3 \1 k. r
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