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。0 ^# K7 t4 r+ I0 t% f$ }! i
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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作者：来自澳大利亚6 [! D2 t# Q/ i( P u) }/ j
来源：Haematologica. 2011.8.9.
+ }6 z8 O/ W, U& Z ?9 L0 XDear Group,2 ~5 D/ I O* n5 f5 t
: L* m3 [1 c8 W9 m
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
6 e9 u7 U7 l; ?therapies. Here is a report from Australia on 3 patients who went off Sprycel" f' S# ~# e7 l0 c, m
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients* S" t5 u4 }: f0 K6 Q6 ?
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
* F; }: R" F) d8 d& f/ Ldoes spike up the immune system so I hope more reports come out on this issue.
r z- C2 _8 O( ~& F" B8 Z+ N
( F. G; C0 W) E; _# H0 d6 W( FThe remarkable news about Sprycel cessation is that all 3 patients had failed
0 V" ^* X% o( j. U* I( Q7 F: {% aGleevec and Sprycel was their second TKI so they had resistant disease. This is# C1 v7 G' G% P0 a( S
different from the stopping Gleevec trial in France which only targets patients
- k5 b9 V7 }7 k# `& d3 t5 I% ywho have done well on Gleevec.
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/ f3 ~7 c; O& q8 T5 M# SHopefully, the doctors will report on a larger study and long-term to see if the
: D; F" K7 o, G* B- h+ z! R# H) k- [response off Sprycel is sustained.9 v& H# W+ f( F+ N9 e
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Best Wishes,1 Q: D, Q+ P. Z4 _; ~
Anjana$ {, s: n! j9 U3 H9 w" ^5 H7 u
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Haematologica. 2011 Aug 9. [Epub ahead of print]
' Q# U0 o% ` M X0 J$ LDurable complete molecular remission of chronic myeloid leukemia following
8 t$ H$ p0 y! }* i# K& sdasatinib cessation, despite adverse disease features.0 o" K! Z7 U. i' w8 {
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
) s8 O* |* y0 M" e4 `Source
" S4 z U h! d( l( ]% Y z& yAdelaide, Australia;+ C9 C( c- ?* V& n; m4 F
0 K; d+ c6 J5 `% E- g1 A( {Abstract& q& u6 t2 v! e# t' Y
Patients with chronic myeloid leukemia, treated with imatinib, who have a
6 `, V% |/ ?/ ^' ~; \durable complete molecular response might remain in CMR after stopping
5 l( W( @% w1 G; r8 }2 Htreatment. Previous reports of patients stopping treatment in complete molecular
! }1 t$ B: _9 I' l+ l/ b+ Q& b& ]- xresponse have included only patients with a good response to imatinib. We
3 L& R5 O5 W/ B1 C9 j+ d) Q6 ^describe three patients with stable complete molecular response on dasatinib
2 s" s; V0 F7 }4 etreatment following imatinib failure. Two of the three patients remain in
: L7 Y4 l" C* Y3 acomplete molecular response more than 12 months after stopping dasatinib. In2 P X4 V4 d( j3 Y& U; m
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
' n! X3 M9 c8 g$ F$ M5 T9 Eshow that the leukemic clone remains detectable, as we have previously shown in7 v- j; _8 B1 k( a5 t# d
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as0 P. ?$ f2 {" ^, {
the emergence of clonal T cell populations, were observed both in one patient
% q$ A' O7 Q2 r, p$ \ mwho relapsed and in one patient in remission. Our results suggest that the& n8 n: h6 @1 x+ ~. ~2 ~) S! K: [
characteristics of complete molecular response on dasatinib treatment may be9 p4 A2 j4 x. B
similar to that achieved with imatinib, at least in patients with adverse; {+ o! J1 ]+ y, V6 l
disease features.# T! x5 x0 b6 M
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