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。* [8 C% p8 `" r+ Q$ F: W; H! Z# f
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。# P2 Q+ D C# g/ c5 }
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作者：来自澳大利亚: h+ f9 T' L6 T/ }( K
来源：Haematologica. 2011.8.9.4 D/ t7 S$ l1 J7 O/ |7 `
Dear Group,
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/ [/ O S! `& `Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML+ y* A; I' X6 l$ T. C2 @
therapies. Here is a report from Australia on 3 patients who went off Sprycel
8 K- r: ^/ K' Rafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
8 g7 t+ `: Q, h1 ^, e! C! Bremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel4 X2 V" y- g% ^/ l
does spike up the immune system so I hope more reports come out on this issue.& ~6 l4 u+ v. Z) B6 f) @! U% N2 Z4 d( }
* n4 F7 u$ p9 |8 s) r1 }& PThe remarkable news about Sprycel cessation is that all 3 patients had failed9 j2 O; S* g/ O# }: L0 m6 R
Gleevec and Sprycel was their second TKI so they had resistant disease. This is: o& l6 l( Y7 j @% ]
different from the stopping Gleevec trial in France which only targets patients
* z1 T7 j" Y6 y" F. Qwho have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the
, [" p8 M$ a# e& t3 G O6 ^/ N$ bresponse off Sprycel is sustained.
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Best Wishes,6 C! l! J4 O/ x& Q) w# [
Anjana
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, b/ i# c q" q5 ?$ w* \
8 r6 p6 q) l8 bHaematologica. 2011 Aug 9. [Epub ahead of print]' A( e/ g" C5 c8 I: }0 o
Durable complete molecular remission of chronic myeloid leukemia following1 C9 A$ F; v0 @! o2 {
dasatinib cessation, despite adverse disease features.
: u* W+ Z9 ~- f; \; H$ u! GRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
. c: _# s" s3 q! a4 wSource
$ l4 h( G$ u: u5 I- U: m, {% IAdelaide, Australia;5 D$ I- Q }7 }/ b
& }8 m0 q$ o6 N: C
Abstract
5 A' [4 }2 Z/ ~& I p, X, I F# R, IPatients with chronic myeloid leukemia, treated with imatinib, who have a
9 J" \: Y' m9 v' ?durable complete molecular response might remain in CMR after stopping
- e# }9 n2 c) T' etreatment. Previous reports of patients stopping treatment in complete molecular( V5 u+ g) m( x" e, T4 Y4 X. d# U
response have included only patients with a good response to imatinib. We
0 d7 n: q4 n- q$ ^5 Zdescribe three patients with stable complete molecular response on dasatinib2 D/ L0 d; U% e4 X5 Q$ C& [5 d
treatment following imatinib failure. Two of the three patients remain in
Q& _; o, V3 Y: @; Ecomplete molecular response more than 12 months after stopping dasatinib. In& r0 |' O5 `5 I9 m& i3 T' F/ M
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
5 D1 _; C7 N+ {' u' ?show that the leukemic clone remains detectable, as we have previously shown in% V3 H4 Z: s, N! G- h( |
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as. R H! B* C( l+ I ~4 _
the emergence of clonal T cell populations, were observed both in one patient
- i, h! E7 A1 c% H& @( r5 L* M; x( cwho relapsed and in one patient in remission. Our results suggest that the- E: x1 w! H: y. h# A( [
characteristics of complete molecular response on dasatinib treatment may be
" r- \* F0 t$ }5 Dsimilar to that achieved with imatinib, at least in patients with adverse
! O% e8 s4 @- R/ R3 Odisease features.) v. r U+ d @) P. e
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