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。
    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。

作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
6 w9 |0 z. r4 C, r8 v+ kDear Group,

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
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
. K. N. z: P) ?& sdoes spike up the immune system so I hope more reports come out on this issue.
& I+ F7 Q! h6 B$ n4 w+ ?, t* B* J( K
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 is
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.
- o" \; I" Z- ?5 o
+ 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.
4 h4 O5 j7 f0 J4 X  k# a
# Y0 C6 o) p# v' L- JBest Wishes,
2 T$ }1 U( O& v0 x- nAnjana
  s. M% d; D3 V3 w$ k
- ~3 A4 J4 k  Y6 T( e  `
! {8 X0 N0 k2 a5 F& G8 x+ k
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.
Source
" {- ]% Q) N& qAdelaide, Australia;
0 ]$ ~. q) r% v9 a; M$ @
Abstract
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
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 dasatinib
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 to
show that the leukemic clone remains detectable, as we have previously shown in
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 the
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.

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。
7 E% V5 c9 c  C3 {    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。
    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。

" g8 j3 H/ s  \. V" F' J1 P2 b作者：来自法国STIM试验
& |7 |* f1 M+ R; V3 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