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。
3 ?1 j8 t$ E) y! o' W& z$ v( r 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。
& ]8 a& a" g' g' b
# n0 ]3 p6 R7 S, w! O& n3 q作者:来自澳大利亚8 @1 {+ j0 e0 X
来源:Haematologica. 2011.8.9.* v4 Y3 I }6 p/ B5 d. h' m6 F
Dear Group,
- P4 x- e7 X- \1 Z/ q7 \) X
) }$ O" C1 O+ i$ L* qSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
. `' f3 y& v6 e# t& btherapies. Here is a report from Australia on 3 patients who went off Sprycel
" p" {+ U5 Z" g+ N$ ?after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
0 f+ G- Q+ M/ _8 N- A: W6 a0 [remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel- b Z- F' q8 D. O! k
does spike up the immune system so I hope more reports come out on this issue.
! p; h( O" T* K+ V' ~6 _9 b, T% q( C/ t1 D d" R
The remarkable news about Sprycel cessation is that all 3 patients had failed, @" ^' ]6 u" G Z' r# | e5 N
Gleevec and Sprycel was their second TKI so they had resistant disease. This is( `& U% R: A; n' i; i1 z& ^
different from the stopping Gleevec trial in France which only targets patients
( e. h9 x( b3 {" d+ k9 E! zwho have done well on Gleevec.# u4 k8 E$ b }2 E5 D( y0 u
8 z" a0 R. \4 s/ v9 ^' L E. ?Hopefully, the doctors will report on a larger study and long-term to see if the% N( N" J/ r. i- Q6 O4 H
response off Sprycel is sustained.
- Q% Y+ ~- k% U: ~9 a5 K9 h# |: b3 V5 D7 [; Y( C. H
Best Wishes,2 q" f P; Y! E1 h
Anjana1 D* G) |; e; b
3 G7 D) ~/ I- L v/ c6 b
1 X" \2 n% j3 u4 Y( D# J# O5 O# x$ t/ e- k( [
Haematologica. 2011 Aug 9. [Epub ahead of print]( q9 f2 B3 T6 [% E- Z3 O V
Durable complete molecular remission of chronic myeloid leukemia following
) `1 V$ p' F* i! X1 Fdasatinib cessation, despite adverse disease features.. I7 u0 u7 i+ C e- a
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.& X! ~9 @. e y: }) z$ Z( w
Source0 h) b* F! i8 b: S7 i% S' R& Z
Adelaide, Australia;
% m6 Q1 g9 n7 t7 Z: e: v, J) k9 L \% n1 z5 I! n+ _
Abstract5 k- j% u% L4 R% O/ n
Patients with chronic myeloid leukemia, treated with imatinib, who have a
( L8 L5 U2 ^, Ddurable complete molecular response might remain in CMR after stopping
$ t, T- I- E: H/ B+ X) P3 `treatment. Previous reports of patients stopping treatment in complete molecular
2 M8 k8 b$ s: h- t$ j0 Nresponse have included only patients with a good response to imatinib. We
* u N" b" n0 Q, k) Tdescribe three patients with stable complete molecular response on dasatinib3 l5 L2 o/ o! I. C/ O
treatment following imatinib failure. Two of the three patients remain in
- m' E7 z5 I+ j; Y# Xcomplete molecular response more than 12 months after stopping dasatinib. In( }% _/ ^9 g1 o) Z
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to1 m) j0 k! U# g* S& M
show that the leukemic clone remains detectable, as we have previously shown in
; `7 C0 b0 s* T, i1 _3 eimatinib-treated patients. Dasatinib-associated immunological phenomena, such as( _3 L% `7 w/ ^) u. x
the emergence of clonal T cell populations, were observed both in one patient7 p- d. E6 d& T+ p9 M$ a2 I, a
who relapsed and in one patient in remission. Our results suggest that the! U3 m$ Z/ ~2 Q3 g+ o/ D
characteristics of complete molecular response on dasatinib treatment may be6 D y4 b4 `, _6 v# K0 B1 w
similar to that achieved with imatinib, at least in patients with adverse
8 O( |' m& G1 y, M# y& A0 C/ Udisease features.
8 Z4 `* ^% g* e& I# _" Q |