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。
- Q" Z' l: r8 d& Y# U0 j, i 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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3 z: {+ C8 T1 x( g9 A- ^7 j作者:来自澳大利亚
! E0 u9 E" V7 O/ a来源:Haematologica. 2011.8.9.0 r" p. i. _: [! n4 m
Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
7 c$ [. f. ^0 p& a$ ?1 _therapies. Here is a report from Australia on 3 patients who went off Sprycel2 N1 t' G/ X$ l
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients: ]6 b, n0 Y1 [) W1 S0 D$ [
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel' E! E3 I, K' i
does spike up the immune system so I hope more reports come out on this issue.9 e: r/ Q+ H! t9 l A; t$ f
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The remarkable news about Sprycel cessation is that all 3 patients had failed* p/ W' z* c. M# h! o
Gleevec and Sprycel was their second TKI so they had resistant disease. This is6 O2 a; F' G5 j: F
different from the stopping Gleevec trial in France which only targets patients C; C v8 D) C% K* k
who have done well on Gleevec., Z1 r5 I8 ^$ o7 a
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Hopefully, the doctors will report on a larger study and long-term to see if the; O0 R' k* g" I+ T/ |9 u* R; a
response off Sprycel is sustained.
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* E' M2 U4 M( Y* V, K. ^8 EBest Wishes,0 y8 ]) Q6 o3 I/ g* S1 w4 N
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]4 q6 c$ M n4 Q( e, |
Durable complete molecular remission of chronic myeloid leukemia following
- J2 V8 N( J! J* T- wdasatinib cessation, despite adverse disease features.
* \* L. B7 M' `Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.7 m4 d- }. p- Q9 ?, n2 C/ k( d4 j
Source
' V. z2 q) d( X( r. t' _% j; aAdelaide, Australia;
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: e5 \0 N# d, K: g- H; V P* `Abstract: R8 b. p* a. a) Z
Patients with chronic myeloid leukemia, treated with imatinib, who have a
) V X0 I- ]; Ddurable complete molecular response might remain in CMR after stopping# i( d1 Z& _- |$ Z. ^5 S
treatment. Previous reports of patients stopping treatment in complete molecular
1 V G6 w7 f p( q+ R! ^( \* v! Cresponse have included only patients with a good response to imatinib. We
9 t4 {4 q1 Z, _2 ~- wdescribe three patients with stable complete molecular response on dasatinib
0 ]0 h, I5 v: F$ v5 c* jtreatment following imatinib failure. Two of the three patients remain in
- t3 s: d! `) h$ P8 Wcomplete molecular response more than 12 months after stopping dasatinib. In; D$ }0 x% S) c! G
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
) l9 T' W* [2 H1 I, `show that the leukemic clone remains detectable, as we have previously shown in
3 [3 f$ l8 O8 C/ @( iimatinib-treated patients. Dasatinib-associated immunological phenomena, such as2 j) h' k U8 Q1 B; B2 w
the emergence of clonal T cell populations, were observed both in one patient) @/ Q, l+ \# z4 ~4 h1 ~8 _
who relapsed and in one patient in remission. Our results suggest that the
, c+ q. W$ p8 Z7 j: H! {' L- v3 Ucharacteristics of complete molecular response on dasatinib treatment may be3 N( ^$ k8 v' t
similar to that achieved with imatinib, at least in patients with adverse
% s/ d& M6 g, x& ndisease features.
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