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。
6 I8 f0 v+ F1 f, n/ ?, U9 s 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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4 H4 `3 T7 n2 Z. D作者:来自澳大利亚+ H9 V/ d+ o" ?& E3 s% y3 D
来源:Haematologica. 2011.8.9.( |2 g4 B; _# m
Dear Group,- Z" s* V% c: E: c3 @
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML6 T w2 T2 }7 v$ c
therapies. Here is a report from Australia on 3 patients who went off Sprycel" \/ C& j4 }% z- n' X( A7 n2 H
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients* m) V4 F/ q( H5 B# h" D7 k
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
* R* J5 N; i/ O4 [2 qdoes spike up the immune system so I hope more reports come out on this issue.
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& K" z) W0 p1 d! b, \5 y- PThe remarkable news about Sprycel cessation is that all 3 patients had failed
# L g0 Z6 q1 ]8 w* zGleevec and Sprycel was their second TKI so they had resistant disease. This is+ q( ]( n& _* D" k3 F6 B
different from the stopping Gleevec trial in France which only targets patients: F. ]& q. }& r( i$ ]% L/ o! \+ `
who have done well on Gleevec.
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2 ^2 n! ~4 |/ VHopefully, the doctors will report on a larger study and long-term to see if the& h5 T/ x2 b# G% p1 ]7 k3 u0 w
response off Sprycel is sustained.1 A4 [# p( G- x# e
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Best Wishes,6 H3 j% A' z8 h2 ]9 z
Anjana6 b: f3 m0 T8 S. J" J
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" z; R7 _3 x: x# l1 {" z9 E6 rHaematologica. 2011 Aug 9. [Epub ahead of print]6 a+ e4 e+ K* x8 U& C
Durable complete molecular remission of chronic myeloid leukemia following
* }- Q1 S. k( o' G! ?/ Udasatinib cessation, despite adverse disease features.
4 I, s R4 v! ?9 XRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
) ?+ R7 H* \5 \% i6 m' rSource
4 d+ b6 u& c; D$ C9 H) D+ UAdelaide, Australia;9 T# b2 G+ ^, H/ J9 U9 L) n
- _; V5 k( U$ U8 U( F+ ?Abstract
+ g8 U- i- t' w" dPatients with chronic myeloid leukemia, treated with imatinib, who have a
; h, G. x8 I+ @9 L7 j2 d2 [3 Jdurable complete molecular response might remain in CMR after stopping4 Y* g1 W0 p, y0 U4 F w/ P A
treatment. Previous reports of patients stopping treatment in complete molecular* r/ [" S C+ @# @
response have included only patients with a good response to imatinib. We; Z0 V% l( _- m4 G1 G8 C: s* M
describe three patients with stable complete molecular response on dasatinib3 C) s, k5 x0 b/ A7 _1 ?, E
treatment following imatinib failure. Two of the three patients remain in/ E* k, N! h8 V* {& a4 b
complete molecular response more than 12 months after stopping dasatinib. In
3 F; y5 h- [' ^6 m% m& l2 S* Zthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to! _ C# |3 R2 F- u& c& \& K
show that the leukemic clone remains detectable, as we have previously shown in
! M% M; g' }/ B5 x% d: Wimatinib-treated patients. Dasatinib-associated immunological phenomena, such as+ \0 o( M! M4 b6 s
the emergence of clonal T cell populations, were observed both in one patient. d: A6 j' A0 P$ K+ ^7 T2 D' `
who relapsed and in one patient in remission. Our results suggest that the' w+ l- x3 W: s: Q- X6 I1 s* ?
characteristics of complete molecular response on dasatinib treatment may be
4 H( `; e0 `4 b4 P' Zsimilar to that achieved with imatinib, at least in patients with adverse
, @! o9 r8 q+ v" @5 M8 J" ldisease features.
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