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。
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作者：来自澳大利亚
! C, o7 Q2 r+ {3 V来源：Haematologica. 2011.8.9.
Dear Group,

- p, v2 p5 f  q( }2 X( Z8 ESome 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
after 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
7 t- j1 r; y& A! ]% I3 }6 cdoes spike up the immune system so I hope more reports come out on this issue.
9 A; r3 @' s0 T7 r6 b
The remarkable news about Sprycel cessation is that all 3 patients had failed
) a1 I- W  d2 f( j; lGleevec 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
; T2 n" ?1 b3 t/ H9 q. }who have done well on Gleevec.
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& B/ K+ A" Y) y# h' A. oHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

Best Wishes,
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
6 j( f3 ?) v2 N! h* m0 u; qDurable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
( ^" G6 X2 {# gSource
Adelaide, Australia;
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+ ~6 B. I( i+ Y! R9 d# m& Y1 U; t- SAbstract
1 G, a8 Q1 [0 c& p. J) m2 ]Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
# D! v( v' A8 eresponse have included only patients with a good response to imatinib. We
6 j* B! J6 U7 K" K! T& Cdescribe three patients with stable complete molecular response on dasatinib
% s5 n0 W7 A) L7 h; {. Utreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
! o$ a6 I& S1 L) ]; ~these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
2 z5 l9 a% Q" r  ]8 k, T6 Ashow that the leukemic clone remains detectable, as we have previously shown in
# r* y( P9 Q, `( n4 P# P1 Pimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
who relapsed and in one patient in remission. Our results suggest that the
7 I2 q! Q) B. ucharacteristics of complete molecular response on dasatinib treatment may be
1 `& q9 m: A0 B. k1 @% |- o/ A# @0 [6 Hsimilar to that achieved with imatinib, at least in patients with adverse
disease features.
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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。
; K  i( h$ M% {4 b    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。
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0 ^& X& {, `5 z% a* b* L  u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