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。
. H0 } h% U% z, q# V" 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。, e* Q2 W8 W$ `/ b' H/ H
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作者：来自澳大利亚' S$ X. W5 T5 o5 R% `* a& x7 w+ L. s8 M
来源：Haematologica. 2011.8.9.
/ Z ]! l' s1 s4 yDear Group,
6 a; K7 O' X' G! \4 P0 [! M
* V; i4 M3 h4 A7 aSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
/ J" j z3 b7 R# ktherapies. Here is a report from Australia on 3 patients who went off Sprycel
( i6 J2 e1 N! K/ G! u& Kafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
- W5 s" _) o* R0 t# Y$ ~$ z2 lremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel/ B( O- o. U% O, p7 A
does spike up the immune system so I hope more reports come out on this issue.# d: Q+ W, m' s$ \' s m
/ f k$ Y" q G, ]7 QThe remarkable news about Sprycel cessation is that all 3 patients had failed% P# B9 h- G7 ~
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
/ i8 {0 E4 |- S1 B5 \different from the stopping Gleevec trial in France which only targets patients
% ^8 e# [/ v9 B/ Ewho have done well on Gleevec.2 x% [- G( z# z
. s2 j' q/ _3 d, c) G0 m
Hopefully, the doctors will report on a larger study and long-term to see if the
5 ]4 K; T2 g+ {0 R' }: h8 Kresponse off Sprycel is sustained.
. X6 W" [4 y# W5 g) u. R
/ r( {, U) b) ]Best Wishes,- q" c' b6 z9 h, D( \
Anjana# ^7 t) L& l0 T- h2 U
5 `' ^ Y, K( B+ f* j. z' K4 d% C; q5 Y6 @ U N
1 a' P: Q8 F; l% c; z; E! Z( CHaematologica. 2011 Aug 9. [Epub ahead of print]
/ ~+ F" N2 N) oDurable complete molecular remission of chronic myeloid leukemia following; T' j& c: b2 G$ ?! Y$ j
dasatinib cessation, despite adverse disease features.
* G5 B) o @5 G0 g- vRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
# i# j: h7 J# LSource
# H" e' o! {7 TAdelaide, Australia;
% I( ?9 `; o/ x0 c, C4 J+ c! J+ c
0 _3 g5 p) p" w! x8 vAbstract
2 z: i8 b. `% d1 TPatients with chronic myeloid leukemia, treated with imatinib, who have a
3 k7 E- t* K+ ~2 Cdurable complete molecular response might remain in CMR after stopping0 B6 T* X: F- {/ n2 Z! {& n2 k
treatment. Previous reports of patients stopping treatment in complete molecular
) f2 U, _* i6 |0 H& u- nresponse have included only patients with a good response to imatinib. We1 d/ i K6 m) Y `2 U3 F
describe three patients with stable complete molecular response on dasatinib
% d, K* E" {% ?treatment following imatinib failure. Two of the three patients remain in2 m, ?+ {) _' a8 j, I" r
complete molecular response more than 12 months after stopping dasatinib. In% U3 c$ m! G% e1 k: v7 A
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
, t5 W; d% q; j w9 oshow that the leukemic clone remains detectable, as we have previously shown in: G2 `# y# L% e6 i5 D
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as% W. l! ]1 e O" E% T7 n& J
the emergence of clonal T cell populations, were observed both in one patient3 I. o* i' g2 D8 V
who relapsed and in one patient in remission. Our results suggest that the
. |# X( U8 q1 V2 rcharacteristics of complete molecular response on dasatinib treatment may be/ _: ^; [3 }) ^5 ^8 ^' x) i
similar to that achieved with imatinib, at least in patients with adverse- f' z6 Y9 q5 N( E' y% K
disease features.& d a/ v* Q8 u# I! E5 X
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