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。

作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
' ^! P' i) s$ s8 u' jDear Group,

2 h9 j  c# l. a. d" MSome 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
" A+ u0 {" L" a" b7 wafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
4 L' D5 l' r. c- b8 ~+ n8 |1 Lremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
+ W: b8 F) C2 z/ h* Zdoes spike up the immune system so I hope more reports come out on this issue.
0 U% U4 B0 m  g$ x1 T/ ?5 c! J- k* c
  O% u( I- S% \0 QThe remarkable news about Sprycel cessation is that all 3 patients had failed
# J3 V' ~" A) i- gGleevec and Sprycel was their second TKI so they had resistant disease. This is
! H' U! [( W3 Z9 Fdifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
9 E- J7 O  r- i) n2 ~
Hopefully, the doctors will report on a larger study and long-term to see if the
$ R9 P4 Z8 P$ Rresponse off Sprycel is sustained.
' i  J% X9 h! |
Best Wishes,
Anjana
' Z, m' s0 o* U0 N- ]0 X


) K4 A' j0 W) {' p& y; f: RHaematologica. 2011 Aug 9. [Epub ahead of print]
: \' |0 M  Q% r, NDurable 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.
+ ~# V4 N" h+ F, S: b# R! r9 u7 |Source
Adelaide, Australia;
: J8 V! b/ E' U& U/ y# m3 q# O* h) G
Abstract
' I9 C8 a5 h# \9 R7 gPatients 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
response have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
9 r/ u' A! t9 ]/ Gtreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
show that the leukemic clone remains detectable, as we have previously shown in
  t9 L$ W7 [# Kimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
% u' s: ~9 _& y" {. j# D5 Q9 \the emergence of clonal T cell populations, were observed both in one patient
; o4 _% ~7 ^; E6 ~! q; D# \who relapsed and in one patient in remission. Our results suggest that the
: v) x0 B; P8 m. U. acharacteristics of complete molecular response on dasatinib treatment may be
4 D# B& L( Z. ?" |) Asimilar to that achieved with imatinib, at least in patients with adverse
9 ?+ U: ?  O; j2 [" q) x+ [4 cdisease features.

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。
3 h# g( x# i5 R  X) f$ N. P# w    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。

# j& E6 _  g; L( d& }$ ?4 o作者：来自法国STIM试验
$ x/ W+ Z( X; a7 }+ J; p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