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。2 f" O" A5 q R( b7 ?
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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* e$ o8 H: H/ d5 F9 j! v* m$ x# y作者:来自澳大利亚
+ a" A8 Y/ z8 C, L0 S来源:Haematologica. 2011.8.9., S* D) _2 p1 p0 K. Z5 o
Dear Group,: ~8 O, G/ `4 @6 ~0 e) Q
) J# _3 Y, b' b) r5 N* C/ k8 dSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
, [8 h5 A' K1 ^' V) R) }6 @therapies. Here is a report from Australia on 3 patients who went off Sprycel P- n% T# k* H7 T8 Z; J
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
4 r& d8 ~$ {1 _6 H. E5 D. sremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
8 w* ], k5 M/ L$ j# v1 O8 r1 \does spike up the immune system so I hope more reports come out on this issue. i2 V" a! y: W1 i# V7 {( |
; ]- j1 s$ ^& m6 E" f6 A5 cThe remarkable news about Sprycel cessation is that all 3 patients had failed i4 G9 \: i; i/ Z+ U+ @0 r
Gleevec and Sprycel was their second TKI so they had resistant disease. This is3 }# [3 q5 x G3 Q$ Y
different from the stopping Gleevec trial in France which only targets patients9 P% c) d l+ \
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. I5 ?: l$ A, o0 ~0 v3 ?2 t: O
response off Sprycel is sustained.
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Best Wishes,
7 h8 U$ M9 ~4 K( HAnjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]$ J& e4 T/ @6 Q: t/ s+ e
Durable complete molecular remission of chronic myeloid leukemia following
7 s# Y, F" K$ \0 Ldasatinib cessation, despite adverse disease features.( }6 @3 g+ T& @
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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Adelaide, Australia;+ B9 f1 n1 u+ S/ l0 T
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Abstract
- z. u- ?) O6 G2 a3 R* j0 q% hPatients with chronic myeloid leukemia, treated with imatinib, who have a. K* `; J2 w5 P1 _( b
durable complete molecular response might remain in CMR after stopping
8 W4 z b2 Y3 v: \3 qtreatment. Previous reports of patients stopping treatment in complete molecular. \( d$ e; m, J
response have included only patients with a good response to imatinib. We% Y9 b5 G# e) x& f7 Z8 z
describe three patients with stable complete molecular response on dasatinib4 A# D8 C9 j0 N
treatment following imatinib failure. Two of the three patients remain in; Q3 c4 Q) `; e3 k8 r
complete molecular response more than 12 months after stopping dasatinib. In
9 e7 k4 [# G+ V, x. [* Vthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
V; b6 P P. z6 F' V* {show that the leukemic clone remains detectable, as we have previously shown in4 C5 N/ p) h. e: ^/ C5 X! h6 ]* S
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
: _* s3 ^4 r t' N+ p8 Gthe emergence of clonal T cell populations, were observed both in one patient [# u' y) k d: ?
who relapsed and in one patient in remission. Our results suggest that the
5 o7 k: T* ^6 j a. u# S# W2 g' W9 }characteristics of complete molecular response on dasatinib treatment may be
: l$ C: f1 n+ Wsimilar to that achieved with imatinib, at least in patients with adverse
: \" t; F1 F# b/ {0 n9 xdisease features.
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