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。: T* x4 L* k" ~' ?3 O
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。; S. i1 ^- P* f& ]
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作者:来自澳大利亚
5 w5 l& G5 `, Y% f! B5 K3 ?3 ]来源:Haematologica. 2011.8.9.$ W/ N: t# y+ _2 C6 U3 S
Dear Group,, ]1 Q* Q6 k8 t/ d1 K' O
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
# L( M+ }3 P: Utherapies. Here is a report from Australia on 3 patients who went off Sprycel8 _, r% t2 m9 l/ N- Z7 c$ d7 S( n
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients. b; ^9 J. X6 s5 {
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel7 w0 J& b. w7 m2 j4 x
does spike up the immune system so I hope more reports come out on this issue.
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4 P9 E) a/ e) b6 m) `The remarkable news about Sprycel cessation is that all 3 patients had failed
( C4 W6 G; ?8 J; ?% C% nGleevec and Sprycel was their second TKI so they had resistant disease. This is( b* P5 u/ z4 n2 t# S2 O3 _
different from the stopping Gleevec trial in France which only targets patients- g" _0 T% o! |5 o
who have done well on Gleevec.; @5 g1 v. ?, ?& d- _
0 x+ B: B6 u/ N( A/ iHopefully, the doctors will report on a larger study and long-term to see if the5 ?9 r2 C& t) i% q8 _# P2 O1 i# r/ f
response off Sprycel is sustained.
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# v6 O. C& u) f5 GBest Wishes,
- u+ w' H: r7 |; h/ OAnjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
4 k! f3 [7 \: T1 O9 h/ _Durable complete molecular remission of chronic myeloid leukemia following
& V7 @/ Z: L8 d1 z3 K( rdasatinib cessation, despite adverse disease features.
- N% s4 ^7 f( q3 I/ b' c8 H- |& HRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
4 N, |1 _$ P6 Z. k: t% Z/ L5 H7 MSource
- L8 @5 r2 p8 A, jAdelaide, Australia;
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Abstract
( T' W' P. J7 n) C' ZPatients with chronic myeloid leukemia, treated with imatinib, who have a
( U% {! s$ ]9 F; O3 edurable complete molecular response might remain in CMR after stopping$ [5 [$ n5 b$ T z" @+ t7 @
treatment. Previous reports of patients stopping treatment in complete molecular
3 ~ Z' D& Y& R7 @5 o% i) nresponse have included only patients with a good response to imatinib. We% `; Z v2 j9 I5 ~, W& N3 N
describe three patients with stable complete molecular response on dasatinib
1 z0 s2 `* |7 r. W. Streatment following imatinib failure. Two of the three patients remain in2 l7 T i( g' A3 r0 _
complete molecular response more than 12 months after stopping dasatinib. In! ?# q& F {) o2 Y0 c* k
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to/ t3 {4 V( m; c4 A, r
show that the leukemic clone remains detectable, as we have previously shown in
/ A4 q- k% v4 r7 Q( X/ Pimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
7 ~" _+ O3 t# d# _/ X( @the emergence of clonal T cell populations, were observed both in one patient: V7 i, i6 e' y% [: { @" q" M3 | \
who relapsed and in one patient in remission. Our results suggest that the9 B5 D4 U, @6 ?- f
characteristics of complete molecular response on dasatinib treatment may be; i8 O/ H+ J# s
similar to that achieved with imatinib, at least in patients with adverse& L7 a0 c) Q) ^' k$ Y
disease features.
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