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。
& V9 m' V' I, R 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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) o9 U$ A6 n! m6 j1 C作者：来自澳大利亚( g: g8 V* M3 |4 q4 `2 ?2 r
来源：Haematologica. 2011.8.9.
+ J- t9 U- ~) m3 PDear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML* N& k( b$ W. v( K' g
therapies. Here is a report from Australia on 3 patients who went off Sprycel+ U9 z9 E5 \/ U# U
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients. Z3 U) A2 L1 H
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
% t# c' @* s# d- qdoes spike up the immune system so I hope more reports come out on this issue.
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! p+ z* J) B+ ~4 R1 m* TThe remarkable news about Sprycel cessation is that all 3 patients had failed' u# E/ V5 N' K( D; d2 q
Gleevec and Sprycel was their second TKI so they had resistant disease. This is$ P* ~1 _$ u5 T5 Z
different from the stopping Gleevec trial in France which only targets patients& \$ F5 a! }0 ^/ s
who have done well on Gleevec.
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, O1 b8 u2 F- J q0 tHopefully, the doctors will report on a larger study and long-term to see if the6 ^' _$ d8 v& g# m H
response off Sprycel is sustained.7 v( W5 `/ \) }$ p+ U4 {& l
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Best Wishes,
" W) e. e; M% z. y: l( ^4 HAnjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
1 C4 A8 f( q! A5 f5 GDurable complete molecular remission of chronic myeloid leukemia following# d2 U- Y7 s) t }8 p: A7 i* C7 k- F
dasatinib cessation, despite adverse disease features.+ O2 M# v8 z6 M! T( h
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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2 ?2 J! j0 l% X* ~6 K/ ^Adelaide, Australia;6 I4 k: A% C$ K% V
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Abstract2 X2 t: T0 H- q) F
Patients with chronic myeloid leukemia, treated with imatinib, who have a [0 @" x5 C0 [0 f0 I0 |# E: b& A
durable complete molecular response might remain in CMR after stopping/ Y% b! G4 ~. n; T z# U6 j
treatment. Previous reports of patients stopping treatment in complete molecular
0 c) G- _' M0 V U5 _1 }response have included only patients with a good response to imatinib. We
$ A* G! q3 j1 I8 A" E$ K- zdescribe three patients with stable complete molecular response on dasatinib; N( [9 f; n; B2 [ z. L
treatment following imatinib failure. Two of the three patients remain in
6 f- b& z- C J" |8 Tcomplete molecular response more than 12 months after stopping dasatinib. In
% h' `, _0 n0 Ithese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
" ?9 ]* J D7 u- B4 B+ Bshow that the leukemic clone remains detectable, as we have previously shown in
; y! |! T# W6 F! L# Limatinib-treated patients. Dasatinib-associated immunological phenomena, such as; q( g! {% o- {& Z9 Y1 F+ i7 O V
the emergence of clonal T cell populations, were observed both in one patient, u4 r7 q ~2 P7 U6 r1 Y
who relapsed and in one patient in remission. Our results suggest that the5 f# ~6 k# G; f+ t! k" N
characteristics of complete molecular response on dasatinib treatment may be
5 W2 |8 y4 H1 J% k0 h" Fsimilar to that achieved with imatinib, at least in patients with adverse# O+ l7 G: G' e( L
disease features.
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