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。
0 F# C* F3 G) {% U1 W( w3 |) ^4 E' w    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。

2 \- q8 @0 v5 Q- _作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,
7 L/ t- K' S# t5 r0 O# O! T9 f
9 W6 e4 ?+ |! t7 A! @# QSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
1 u$ e: ^6 v9 Z; j6 |! k& Ztherapies. Here is a report from Australia on 3 patients who went off Sprycel
after 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
does spike up the immune system so I hope more reports come out on this issue.

# F9 q* t3 [* @/ n+ W! FThe remarkable news about Sprycel cessation is that all 3 patients had failed
/ j3 p4 w' P+ ^% j$ E8 \1 U; U7 QGleevec and Sprycel was their second TKI so they had resistant disease. This is
different from the stopping Gleevec trial in France which only targets patients
  r" ]% ^# J$ M# _$ Nwho have done well on Gleevec.
1 H- M/ E" c! N8 r3 e
: E6 C0 C" a& YHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
( q/ |( G/ G4 W# Y: w# V% F
8 x) R+ D/ [; ^7 E2 f% |4 ]Best Wishes,
Anjana


9 n. L: p" l* |, o( U
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.
6 S. q) O+ j6 d8 h: RSource
' s7 v" h  U3 N" k5 ZAdelaide, Australia;
7 S4 Z* H! w1 [. s4 n4 a( f
Abstract
* ?6 B6 K/ b8 l1 F* fPatients with chronic myeloid leukemia, treated with imatinib, who have a
0 m  B' a% [# v0 Zdurable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
5 l& Z6 z& A* x+ kresponse have included only patients with a good response to imatinib. We
+ R+ R2 H" M$ qdescribe three patients with stable complete molecular response on dasatinib
0 ~4 F* J4 W1 |6 J+ s. `treatment following imatinib failure. Two of the three patients remain in
5 N( }" Q$ I: u1 D9 z5 a: v1 Pcomplete molecular response more than 12 months after stopping dasatinib. In
, r( D- ?9 p- u" A8 D) `3 athese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
* S& ?% x! I, v# J3 Ishow that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
4 R& |/ r' y- U$ Athe emergence of clonal T cell populations, were observed both in one patient
# `6 U) c$ |- ^6 U/ H0 [9 P4 Twho relapsed and in one patient in remission. Our results suggest that the
characteristics of complete molecular response on dasatinib treatment may be
" i. o$ y- `  X$ s7 j5 _- ssimilar to that achieved with imatinib, at least in patients with adverse
# j' i" S# j, `/ `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。
. Y9 I: P9 A8 o4 u8 n    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。
3 Y  q8 i" V  N5 L6 m    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。
( z! x$ |4 b0 H8 G4 I7 o
/ j8 T9 g* x' Q7 M. K( N9 z9 r作者：来自法国STIM试验
; Y- y9 @; ^7 n) l0 y$ s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