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。

作者：来自澳大利亚
% X- p6 n0 r# Y1 k: }5 x来源：Haematologica. 2011.8.9.
Dear Group,
6 `; J! g& M9 i4 B# J. b+ S7 o4 N5 X
- X2 C* z  Z3 d+ ]4 LSome 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
3 F" H8 ^* R$ B, R% Fafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
" E. F6 V& b' I. Dremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
" w% p% q) N& ?/ O' Kdoes spike up the immune system so I hope more reports come out on this issue.
- t/ i4 j+ r- Z; n
) x" a0 T" w6 Z( l3 |The remarkable news about Sprycel cessation is that all 3 patients had failed
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
different from the stopping Gleevec trial in France which only targets patients
4 c! a2 U1 [& j3 swho have done well on Gleevec.
3 }0 E% s/ h4 W) u8 }
Hopefully, the doctors will report on a larger study and long-term to see if the
3 f5 P4 G9 J( Wresponse off Sprycel is sustained.
# D) ~: H, U- Q, D/ A* I4 e, ~: H
Best Wishes,
' H4 i( N3 k, WAnjana



' ^) T* O! D# |3 J. k! w' VHaematologica. 2011 Aug 9. [Epub ahead of print]
3 l4 L: A" i) Z# i; _: Y- nDurable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
9 S" c* C$ v- s% Q6 e0 ^% z& A: KSource
* f0 h) `5 t& Y! }- D0 R; tAdelaide, Australia;

Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
. }- j* Q9 r: U) y/ r* lresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
- S5 m! ]% M% J. o1 f  ocomplete molecular response more than 12 months after stopping dasatinib. In
  q3 X& O$ i& F4 m& Qthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
8 c' I+ B8 K- ashow 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
1 [+ t$ h! V' d2 s: Z1 |& q& s& ncharacteristics of complete molecular response on dasatinib treatment may be
+ o6 _7 P: Y6 P! o" Usimilar to that achieved with imatinib, at least in patients with adverse
disease features.

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。
    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。
    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。

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