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
来源：Haematologica. 2011.8.9.
" s; J! q6 I5 _8 \Dear Group,

" _1 L. D1 Z% ySome 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
+ P" U: s- l) N) O: A/ Bafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
: B$ Y2 V% j$ w2 z: wdoes spike up the immune system so I hope more reports come out on this issue.
& [+ _2 G' Z" _* x5 }( {/ ^7 t
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
0 H  V, p4 U2 u) {9 [( ?different from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
2 r, f" w# s* s! \8 U
) h: o( q! {: U3 dHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

Best Wishes,
Anjana
8 j7 r& W6 B% g' s0 c* c
9 v+ h% y4 F! @6 h+ V. p- m

Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable 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.
& c9 \; I" n" ~6 x1 `Source
; \6 E% K& n% y) x, W" g1 E7 MAdelaide, Australia;

  |; y6 a5 L7 G* z/ Y8 gAbstract
( t) n+ g1 i. APatients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
- d  C" G) w& Y9 Y/ M  j( |treatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
# j. W3 X- f) cdescribe three patients with stable complete molecular response on dasatinib
' w% ^  s8 a: N/ s% y7 E3 [treatment following imatinib failure. Two of the three patients remain in
8 z. q. Q8 e5 [' ?" m  ]+ kcomplete molecular response more than 12 months after stopping dasatinib. In
4 o2 O1 a0 J* T- G/ fthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
show 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
6 D" `' U8 _& V" l9 C1 J2 awho relapsed and in one patient in remission. Our results suggest that the
0 f- }% [; f4 I2 g' }; Z( Hcharacteristics of complete molecular response on dasatinib treatment may be
similar 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。
8 }5 j% Z3 C; b: g% ]  f
) R7 W+ P9 d* E3 Y" W& Y/ |; ]4 h作者：来自法国STIM试验
8 \% P# y' \$ Q+ X; {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