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。% V+ C5 [. @+ ]. W7 f0 E
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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作者：来自澳大利亚: L2 x; q# ]) i' C
来源：Haematologica. 2011.8.9.
2 n9 A; w5 o9 P! |% {9 e/ [Dear Group,
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& V2 X" Z: ^" ^: i4 USome of you are on Dasatinib (Sprycel) and we wish to give news on all CML9 B2 O8 I: @0 `, S( Q
therapies. Here is a report from Australia on 3 patients who went off Sprycel
) k3 P9 P# X+ j% Z% l0 Eafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients7 M9 h: {4 T" ^$ a
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel: t2 K# l6 }4 y; p- c
does spike up the immune system so I hope more reports come out on this issue.
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The remarkable news about Sprycel cessation is that all 3 patients had failed$ z3 j: ?( e9 ~
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
& P" Z! A+ L! _! gdifferent from the stopping Gleevec trial in France which only targets patients
3 ^9 R4 G, Y! l, rwho have done well on Gleevec.# J/ I1 ]% S# t. q1 v5 Q* }
' }7 W6 C- _+ K+ q* FHopefully, the doctors will report on a larger study and long-term to see if the$ c4 i8 X9 a8 S* B' A2 R& X! V8 E
response off Sprycel is sustained.
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! C( P l5 b# g3 U' KBest Wishes,( ^/ I1 o( J( p9 b$ H" g9 b
Anjana
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% L0 Z6 N* @9 s! QHaematologica. 2011 Aug 9. [Epub ahead of print]
' W7 x9 [% a0 N6 z* Y. VDurable complete molecular remission of chronic myeloid leukemia following R$ ^/ V! B- |7 `
dasatinib cessation, despite adverse disease features.1 G( A7 Z# m( _* h; S
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP." u+ L- m3 ?. f) G' z J. Z
Source& ]- N2 a/ a* x6 D% j
Adelaide, Australia;2 k: o+ N9 W6 j6 Z$ q7 {
" J4 E# U/ \3 @& q, pAbstract) O7 Y' g* |& x- V
Patients with chronic myeloid leukemia, treated with imatinib, who have a
: d1 q {! j0 h# e0 ldurable complete molecular response might remain in CMR after stopping
# F7 Z; ^# f* I# Ytreatment. Previous reports of patients stopping treatment in complete molecular
7 R. W4 O$ n2 e, G6 W0 [response have included only patients with a good response to imatinib. We
- o" j* }% f( M# Udescribe three patients with stable complete molecular response on dasatinib
# L2 n9 v; v3 \4 Gtreatment following imatinib failure. Two of the three patients remain in: v' C4 O) T8 _+ N8 [
complete molecular response more than 12 months after stopping dasatinib. In, @, r+ z4 }" a s. j. O
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to, N' W. A$ s& |
show that the leukemic clone remains detectable, as we have previously shown in9 Y3 v) C) u; A" L x* X5 k% u1 K
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as. ]; y: ~2 {1 O* L' |8 Y( e- g$ o
the emergence of clonal T cell populations, were observed both in one patient
1 |+ b$ W, J p) |who relapsed and in one patient in remission. Our results suggest that the2 X8 `! B3 H- a1 Q* B9 {
characteristics of complete molecular response on dasatinib treatment may be/ N7 f1 R4 e% J0 \: u B+ X+ \4 N4 H
similar to that achieved with imatinib, at least in patients with adverse
8 m. y6 {, k+ C* Xdisease features.9 D, @3 a3 |8 p
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