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。
; Q3 Y, i7 U: K$ v5 Y; Y    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。

5 h0 `# Q. {$ E% F( O! R作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,

' h( G- _6 _! V) i2 j, n) PSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. 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
. Z. ?; `, K* _8 @+ j! P+ T6 E3 Premain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
+ \1 P9 l7 A  K& z3 w7 d0 xdoes spike up the immune system so I hope more reports come out on this issue.
' o3 d  K1 o( g$ h7 P5 H
The remarkable news about Sprycel cessation is that all 3 patients had failed
! A5 X9 ?( i% }, `Gleevec and Sprycel was their second TKI so they had resistant disease. This is
& k! K& U0 g5 vdifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
* v: v; ]0 b' B/ b, W4 `
Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

Best Wishes,
+ c  u5 R% c/ w# D- dAnjana

% e0 i9 ~' k9 N' r% }
3 K- R+ w8 H# f1 ^2 V1 V
# g6 U* j6 S$ X+ I, s4 MHaematologica. 2011 Aug 9. [Epub ahead of print]
7 W% _& B) q) K" M& Z8 d8 p& r" UDurable complete molecular remission of chronic myeloid leukemia following
; |- S1 M, D: R4 b* [9 ?dasatinib cessation, despite adverse disease features.
7 Y  P' W# z9 |( V- a! I. v( \/ QRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
7 F" [; m+ P6 c/ }8 u- w, S$ WSource
Adelaide, Australia;
7 o! n3 t. r9 T: V1 a! V3 o- S) x1 X
- Z' B+ d+ G8 w0 A% u6 ]Abstract
7 g  {! ^+ z+ Z8 ?Patients with chronic myeloid leukemia, treated with imatinib, who have a
* ~6 `5 {8 m* k% |  n! P% O5 `' sdurable complete molecular response might remain in CMR after stopping
% a4 e/ }) q& F1 Y8 Itreatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
7 Z: O+ X% D% @; @' Etreatment following imatinib failure. Two of the three patients remain in
" ?8 b8 S' f; o. J; y- Xcomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
show that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
" U9 Q2 w4 i6 j3 Pwho relapsed and in one patient in remission. Our results suggest that the
  x+ I5 e5 D/ T& e6 O- r4 Ucharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
disease features.
6 @% p; F' W% h

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。
. q9 t$ K- t' ?1 {    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。
  L' d' o; o  u, b3 x" U    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。

: |+ C5 F. q1 D8 R7 m' M" s作者：来自法国STIM试验
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