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。
9 g( _. n: B; W6 r+ e8 r" n2 Q 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& \/ F" _: f5 o, O' d# A9 ^
来源：Haematologica. 2011.8.9.
# C) O# |6 n+ ODear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
. k( p" K* J: T* q. ]% ktherapies. Here is a report from Australia on 3 patients who went off Sprycel9 G. w8 x2 r, U, u2 r* V% U* Q
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients Z3 i1 i9 t/ [+ M8 |
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
. x- i3 z6 i* B- o8 {0 mdoes spike up the immune system so I hope more reports come out on this issue.
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The remarkable news about Sprycel cessation is that all 3 patients had failed
" O4 d, W6 I2 `) C4 gGleevec and Sprycel was their second TKI so they had resistant disease. This is9 F+ _9 @* l. n; K8 V
different from the stopping Gleevec trial in France which only targets patients
, ~. k/ M) N) O" x, m/ g1 w3 Gwho have done well on Gleevec. Y9 W8 B9 S6 V1 x' J
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Hopefully, the doctors will report on a larger study and long-term to see if the1 L& R1 T+ d: s( O# z
response off Sprycel is sustained., F$ V9 ~) _% O8 i
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Best Wishes, i' o* u9 K/ J& g7 F4 ?% r
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]7 M% x/ u. N/ A% }
Durable complete molecular remission of chronic myeloid leukemia following" i/ Q }# U& @7 J" G( C/ C; M2 @
dasatinib cessation, despite adverse disease features.
+ z q. u3 X. K+ @8 Y1 zRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
% e% r2 `1 Y- ?* t& V3 DSource
& u7 V/ c7 g& jAdelaide, Australia;
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Abstract
; C& s+ [: p# Y8 R9 t! XPatients with chronic myeloid leukemia, treated with imatinib, who have a/ G7 _. M9 b- A* h
durable complete molecular response might remain in CMR after stopping
, k% k" b) |# C+ jtreatment. Previous reports of patients stopping treatment in complete molecular7 U0 n( N, ]+ S) Y' x4 b0 P
response have included only patients with a good response to imatinib. We# b" U' ^; p. t- c9 ], r* o4 s
describe three patients with stable complete molecular response on dasatinib
) @( E" k0 }, e" A) Itreatment following imatinib failure. Two of the three patients remain in
# M& I4 I& V4 t- Wcomplete molecular response more than 12 months after stopping dasatinib. In
; q0 Q2 a! @, d. X! Y+ `7 G8 Uthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
, G3 k6 ]; S' q# cshow that the leukemic clone remains detectable, as we have previously shown in
- c- I8 F Y; j* y& k/ N1 [imatinib-treated patients. Dasatinib-associated immunological phenomena, such as3 a0 S" q* {7 S0 f/ \5 }
the emergence of clonal T cell populations, were observed both in one patient0 C0 F+ N5 T3 B# ^$ v; {1 K. a
who relapsed and in one patient in remission. Our results suggest that the
/ H% T4 D3 i3 U' |- |) Y$ \characteristics of complete molecular response on dasatinib treatment may be
7 a' E% b2 z% j; Fsimilar to that achieved with imatinib, at least in patients with adverse
5 W8 G5 E: a/ @3 N; a8 pdisease features.% M& V- F! H3 B6 {
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