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。
1 r) c* \9 \/ `8 I 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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$ ?8 G* d5 f2 _作者：来自澳大利亚
7 H0 e0 S( B2 F: |5 ?) k来源：Haematologica. 2011.8.9.
) d9 p3 S( k& F |6 ~. xDear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
& l3 r. |# I9 b; V! G' r4 rtherapies. Here is a report from Australia on 3 patients who went off Sprycel5 F/ {2 C6 D% s G2 Z
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients- ~+ `7 N, M( y( R+ Q
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
) V9 V7 K- K S; z+ Ddoes spike up the immune system so I hope more reports come out on this issue.) ]2 e4 I/ z7 u" p% d; M: V9 R
% d# l8 c q7 \# {: V+ Y S+ O# SThe remarkable news about Sprycel cessation is that all 3 patients had failed
; @4 n$ e1 F* ~! YGleevec and Sprycel was their second TKI so they had resistant disease. This is
" F4 _$ n1 ^# J& xdifferent from the stopping Gleevec trial in France which only targets patients
, r: Y8 e. _1 g6 {) Kwho have done well on Gleevec.
+ v4 K" c! E* z* d1 g+ S& _3 _. i
2 t: e& M z, |% i3 U* iHopefully, the doctors will report on a larger study and long-term to see if the4 v( A+ E! g; g6 |% V* O! ~
response off Sprycel is sustained.# U" W- a# R3 x, }. P8 Z
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Best Wishes,# Y) w8 Q/ M: A- H, X: _
Anjana+ ^# u5 ^7 m% n7 e0 l1 Y# ^9 _
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2 X/ d1 u: C. WHaematologica. 2011 Aug 9. [Epub ahead of print]
" V1 Q. ?: S' kDurable complete molecular remission of chronic myeloid leukemia following
6 D2 c; [* D2 K' s+ a! m( S$ gdasatinib cessation, despite adverse disease features.
W# D3 s r. ]' s! R/ BRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
# \' Z8 _9 z5 nSource, J6 t3 ^8 E. m0 W% x1 P
Adelaide, Australia;% M* j; i4 [/ Q( D- m) x' i# f
5 }- \/ |) F! c9 }5 G& A
Abstract
+ L' S; y9 Y. u8 b: b7 CPatients with chronic myeloid leukemia, treated with imatinib, who have a: C* V( i( o7 q- Z! _# O$ Y O
durable complete molecular response might remain in CMR after stopping
/ d8 [2 D( [3 }5 Atreatment. Previous reports of patients stopping treatment in complete molecular& G: g- [- _6 ?7 v2 p5 |
response have included only patients with a good response to imatinib. We
# [ c! z# |, V6 f W; H* `describe three patients with stable complete molecular response on dasatinib
. O$ b: C$ [9 @treatment following imatinib failure. Two of the three patients remain in
S' `9 G0 Y; _, [; Wcomplete molecular response more than 12 months after stopping dasatinib. In
+ @- X) L/ d/ {3 r4 }these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
7 {2 Q4 {7 F: V7 ~0 ]1 Z+ H& kshow that the leukemic clone remains detectable, as we have previously shown in
# J) c6 e0 f8 H4 v0 Cimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
# @5 ~8 a+ y8 k) ^& Ythe emergence of clonal T cell populations, were observed both in one patient& |4 y4 m4 A4 D3 L) ~* ]2 X
who relapsed and in one patient in remission. Our results suggest that the
7 f% q5 e: N y; M- Mcharacteristics of complete molecular response on dasatinib treatment may be8 c/ Q9 Q# X0 P' A3 S
similar to that achieved with imatinib, at least in patients with adverse
" Z( K* E R: Q b! c$ D4 d/ pdisease features.( {6 F( [% O2 i' \4 b/ V3 B# d
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