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。
+ Y+ e7 Z" r. V8 H* @0 k; j 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。. ?- z! q$ B$ ~% B1 }" e/ ]; z
% X: c/ z- t8 k1 U ?$ j作者：来自澳大利亚$ T6 c+ Q! I( G
来源：Haematologica. 2011.8.9.
# w3 d/ V0 d% j& l, v; lDear Group,
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' |& s$ Q- j1 M+ E* j: ISome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
- I9 c) S; X: \9 Z. ~ Ftherapies. Here is a report from Australia on 3 patients who went off Sprycel
/ e$ X4 i4 V& h, Y; ^" T Bafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
. n) M' f7 I( u+ e% |9 Oremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel$ P1 E- m* C1 E/ S3 x3 E, S. B
does spike up the immune system so I hope more reports come out on this issue.( _! y: u. l: Y
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The remarkable news about Sprycel cessation is that all 3 patients had failed t" a0 ~. ]# W' H2 c8 l
Gleevec and Sprycel was their second TKI so they had resistant disease. This is0 w( H% S; ?( n4 u/ [( ?. h
different from the stopping Gleevec trial in France which only targets patients
4 U2 t; J, q7 e' Dwho have done well on Gleevec.
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) `/ I/ j! s7 c+ T$ q7 M+ u9 NHopefully, the doctors will report on a larger study and long-term to see if the: L1 b" |1 u4 b, I0 k9 f y
response off Sprycel is sustained.
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" _, ?% k! e7 G/ C$ {4 M" g8 J/ x- dBest Wishes,
~/ d, d* n1 F; K! w1 h- cAnjana! y: z5 A7 q j, n( {
+ [( o3 C5 I- W( R% M
+ `' c2 y9 t- j$ G, K
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Haematologica. 2011 Aug 9. [Epub ahead of print]6 X2 a) [4 l7 y3 j
Durable complete molecular remission of chronic myeloid leukemia following$ `: a+ M! d# T
dasatinib cessation, despite adverse disease features.
4 j: ?" h) M3 R3 u# V7 TRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
: t5 ]8 ~/ z7 T$ b9 C4 ?Source
( P$ w) E3 z7 s) IAdelaide, Australia;
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Abstract
. T+ U5 n9 ?! W0 P$ c, W3 QPatients with chronic myeloid leukemia, treated with imatinib, who have a8 S) o% v( |: [) C4 n. y
durable complete molecular response might remain in CMR after stopping- k( D& M* I# s/ |' n
treatment. Previous reports of patients stopping treatment in complete molecular
" G9 d2 R0 A! }9 L# s6 ?2 Aresponse have included only patients with a good response to imatinib. We
* N8 |! h# x' n1 n; Q* w+ v4 odescribe three patients with stable complete molecular response on dasatinib
# q+ [% V5 H3 e6 h; W) q- e) L# ntreatment following imatinib failure. Two of the three patients remain in7 h9 b$ U9 }' u, N9 t
complete molecular response more than 12 months after stopping dasatinib. In Z, i0 f: ~' @* Q
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
/ D# [) V* _# x' ^4 u( yshow that the leukemic clone remains detectable, as we have previously shown in/ N5 L, E# l4 p$ t* g
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
2 w% N8 f- g$ z1 Y3 X5 D' Ithe emergence of clonal T cell populations, were observed both in one patient2 W% H( E6 w; G/ K+ D- l' K
who relapsed and in one patient in remission. Our results suggest that the
$ K) @$ P" I8 y. d3 ?/ ^characteristics of complete molecular response on dasatinib treatment may be j. z0 C& x4 A7 I, B0 l
similar to that achieved with imatinib, at least in patients with adverse
' K, ` S9 y# p& r. i' Bdisease features.
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