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.
) x# f5 G. ?- }: a5 jDear Group,

% V7 v" |/ A: NSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. Here is a report from Australia on 3 patients who went off Sprycel
9 S* U6 Z9 F& E' A. ~- qafter 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
does spike up the immune system so I hope more reports come out on this issue.
5 m. f3 a, q$ p* P8 }; T+ ~) j8 l
9 R" Z0 U; t% X- }+ L9 u( C( [  zThe remarkable news about Sprycel cessation is that all 3 patients had failed
' F9 X/ q+ `% s4 D; I8 qGleevec 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
6 F- [" ?$ G; H! u) v- Jwho have done well on Gleevec.
! d1 d/ ?% r/ F* j+ m. C
: B, U" U; H6 `7 w; B8 {6 ^, PHopefully, the doctors will report on a larger study and long-term to see if the
1 D7 K& C$ g9 qresponse off Sprycel is sustained.
: V# M8 H# T' G8 {4 }4 E0 e" }
Best Wishes,
Anjana
* `# u: a; q' {8 M/ [


Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
! y. z  e- D' H, `8 @% S4 R; kdasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
# W7 H5 O- Y$ K; d) \4 M  uSource
9 ]5 g- s! V4 H, qAdelaide, Australia;
8 L8 l0 f) W9 k3 F& V5 _; U
+ z  p/ q3 u8 K6 u% qAbstract
0 Y  U: D$ Y1 y- D2 zPatients with chronic myeloid leukemia, treated with imatinib, who have a
# P7 |4 ^  U2 x& d1 D$ l1 y+ R" vdurable complete molecular response might remain in CMR after stopping
0 a- i+ T; I% ]9 }treatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
3 d$ K" U- j: \; \complete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
# I2 }' `4 W* _' h9 Y2 ]7 ^show that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
4 x6 C; f, f; o1 z5 [; {the emergence of clonal T cell populations, were observed both in one patient
1 W) q( }, T& Pwho relapsed and in one patient in remission. Our results suggest that the
characteristics of complete molecular response on dasatinib treatment may be
# W8 c7 \$ W  W0 qsimilar to that achieved with imatinib, at least in patients with adverse
disease features.
8 Z' y& z8 G: y# G. Q3 D3 {" X5 U

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。
    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。

作者：来自法国STIM试验
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