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。
7 g t1 ~9 w# t 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。& m- Q9 Q! ]' o/ C. X
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作者：来自澳大利亚' l/ J: Q! \7 X3 y
来源：Haematologica. 2011.8.9.
* N T6 J( w9 gDear Group,& w C* {+ m( _7 A
$ h- z" K y5 `Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML, i) V) H/ a& J2 M7 a& R, n
therapies. Here is a report from Australia on 3 patients who went off Sprycel
; E4 E& T- A+ k$ `8 b! [/ w. Pafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
; L/ W; R' Y- Q! mremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
9 d! ]0 \8 I& e# F: t! adoes 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
6 B# I7 X5 i8 a+ }Gleevec and Sprycel was their second TKI so they had resistant disease. This is0 j0 f: }% u! O; N
different from the stopping Gleevec trial in France which only targets patients! I; ]* E) K5 N& I" `
who 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
/ ~0 v7 V0 F( |& E" B- ?response off Sprycel is sustained.
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( J% |& J' Y! h0 m* H; ` HBest Wishes,; l$ z- s# W s e
Anjana* m6 |8 [7 L$ Z: ]9 r' h, D% [* c# w
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Haematologica. 2011 Aug 9. [Epub ahead of print]% G& g) i( ~$ F. ]; O
Durable complete molecular remission of chronic myeloid leukemia following" l5 ]' |* ?, |2 Z
dasatinib cessation, despite adverse disease features." w1 ]3 z6 c- X- ~% c# I5 j) I* D; j
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.( Q/ O& ?6 E. B* \2 n: b
Source& o$ u- i9 v) ?& u# i
Adelaide, Australia;# t# T: _; a9 f1 V
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Abstract5 f/ Z( T I4 f3 P6 ]3 b" H* v# n
Patients with chronic myeloid leukemia, treated with imatinib, who have a- U* {. K' M# n5 @0 ?! r. f
durable complete molecular response might remain in CMR after stopping
. ?1 s2 V( _5 [8 xtreatment. Previous reports of patients stopping treatment in complete molecular2 Z v8 Z0 n5 m: i
response have included only patients with a good response to imatinib. We; D& G4 t' \7 {( V( O1 {5 F
describe three patients with stable complete molecular response on dasatinib
9 E( W# Q) S5 R. ?# ?/ Jtreatment following imatinib failure. Two of the three patients remain in
0 M( B4 {9 M# j7 ~' I5 x5 ]complete molecular response more than 12 months after stopping dasatinib. In
& P7 S' Q/ }* Z7 s# l/ Z. lthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
5 b$ ~8 c, m fshow that the leukemic clone remains detectable, as we have previously shown in, o# i& I0 I0 A! \7 o% F% U( e4 i
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
, e! P- h$ m+ S6 }; Rthe emergence of clonal T cell populations, were observed both in one patient3 O7 N$ m z }4 i; G
who relapsed and in one patient in remission. Our results suggest that the
! Q( I% f( t- w' L9 _" x0 fcharacteristics of complete molecular response on dasatinib treatment may be
9 q; W9 h& Z. Lsimilar to that achieved with imatinib, at least in patients with adverse/ y, q8 ~9 Z0 H4 ~% [( f5 d
disease features.
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