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。) m# d3 C! C1 F! W E# f# f. A+ C
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。8 n4 _. ]1 ?2 c
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作者:来自澳大利亚1 e8 S# O2 z/ v$ w6 l
来源:Haematologica. 2011.8.9.
6 w9 |0 z. r4 C, r8 v+ kDear Group,3 V+ n: O$ I' U' c$ `
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
. C" C6 Y) ^9 ]1 _/ r2 X: k# Mtherapies. Here is a report from Australia on 3 patients who went off Sprycel- Z/ ?% T4 l8 a1 ?; j- P
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients9 B/ n0 `6 J' q
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
. K. N. z: P) ?& sdoes 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
( G5 R5 }( N$ V L& T1 b: UGleevec and Sprycel was their second TKI so they had resistant disease. This is7 x5 l0 J& q! v) r O0 F" q! g8 g
different from the stopping Gleevec trial in France which only targets patients
& M; u' G( n4 P7 ] o+ x+ Dwho have done well on Gleevec.
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+ D- ]/ ?0 u1 `" S. ~! ?- nHopefully, the doctors will report on a larger study and long-term to see if the
' C) D/ Z8 _; v9 x. h8 eresponse off Sprycel is sustained.
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# Y0 C6 o) p# v' L- JBest Wishes,
2 T$ }1 U( O& v0 x- nAnjana
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2 I7 Y1 {2 `( B: ^! A5 ?' DHaematologica. 2011 Aug 9. [Epub ahead of print]
* }" L7 R( R: k1 H8 @5 e9 v! F HDurable complete molecular remission of chronic myeloid leukemia following
& O& S& Y! T# zdasatinib cessation, despite adverse disease features.
4 c, Y& S7 ^3 K$ y# nRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP., ?4 v" G8 `! [' R }' Y$ J! [ l) a
Source
" {- ]% Q) N& qAdelaide, Australia;
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Abstract W% v* y5 p' s$ R. y6 B) b
Patients with chronic myeloid leukemia, treated with imatinib, who have a
+ i" ^5 l/ N) x, g' V/ h1 Q8 }durable complete molecular response might remain in CMR after stopping; M- Z4 [. H1 l. P. n
treatment. Previous reports of patients stopping treatment in complete molecular
! U! m4 b# V. \' N- F, \* Nresponse have included only patients with a good response to imatinib. We
' l. U, h$ _ d* w! ddescribe three patients with stable complete molecular response on dasatinib1 ?: W. G% M9 w5 N
treatment following imatinib failure. Two of the three patients remain in
; A, W5 Y1 B$ e8 wcomplete molecular response more than 12 months after stopping dasatinib. In
* k6 E7 G' L2 V5 R% X. |9 [these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to5 X: ]: X- s4 ?" U
show that the leukemic clone remains detectable, as we have previously shown in. R( w" t7 a8 p2 E
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
6 Z6 S: ]# m) c; nthe emergence of clonal T cell populations, were observed both in one patient
5 D% \( W" d$ D+ Swho relapsed and in one patient in remission. Our results suggest that the2 D0 ?+ ~# f+ u$ K
characteristics of complete molecular response on dasatinib treatment may be
0 R- F) R! M' c$ {' v: J5 isimilar to that achieved with imatinib, at least in patients with adverse
5 j" d+ }% z; I( p5 y% S) {' R/ @+ [disease features.1 ^1 y) P& j( \6 C1 t9 s
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