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 O1 O2 d6 v; D# |2 z 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。- W3 Q5 I* G9 K1 z4 D) z
: ?; d& R2 }/ x$ s% A Q作者：来自澳大利亚
1 E3 e& W+ j" `! d来源：Haematologica. 2011.8.9.
* V: K& b$ @% a, J# ~Dear Group,8 {& F. K5 A2 f. z% G, C$ X0 o9 H; T
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML$ A9 a; H2 _7 A# A
therapies. Here is a report from Australia on 3 patients who went off Sprycel- [5 T( d' Y' p) l
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients( q* y9 k1 J1 V/ b! r$ R( }9 R
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel8 x, @# S, H$ c0 E
does spike up the immune system so I hope more reports come out on this issue.1 ?# O4 |& C I! d7 P
, D8 _6 M( F& Q h- B; pThe remarkable news about Sprycel cessation is that all 3 patients had failed
$ g" X Y7 g7 U% \* Q3 A8 [- ^5 HGleevec and Sprycel was their second TKI so they had resistant disease. This is
- A" j) T n3 Y1 e& t' Gdifferent from the stopping Gleevec trial in France which only targets patients+ f1 k! W) m7 [0 L8 z
who have done well on Gleevec.
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l! [6 J8 a& P; x4 aHopefully, the doctors will report on a larger study and long-term to see if the) Z& J. M' m+ G6 j
response off Sprycel is sustained.
7 h) V9 @- h3 |, ^0 M3 A3 \* K& X, o* Z
Best Wishes,
% P0 Q0 s* a6 P2 y. ^' dAnjana3 M9 Y" x! e) v4 l U
2 @4 e2 t7 }3 l" W2 c
, \0 T2 _3 B! g8 h" _' b7 J# X4 u+ j x0 [: n }) ]* ]( t }4 ?
Haematologica. 2011 Aug 9. [Epub ahead of print]
0 U& I3 m5 B6 J- T% @# O) zDurable complete molecular remission of chronic myeloid leukemia following
8 c6 N" s6 l; X' j$ J$ G- y0 u" p, D/ bdasatinib cessation, despite adverse disease features.
& ^1 \2 e, P9 l+ N, J1 e: m% Q! |Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.8 N: F8 `. T2 c8 r
Source5 ^% F2 Y0 o3 t0 d
Adelaide, Australia;
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Abstract& d) h4 Q. T" I
Patients with chronic myeloid leukemia, treated with imatinib, who have a$ a2 F) ]" O `3 [8 l- V. ~
durable complete molecular response might remain in CMR after stopping h0 d* l" X+ F% d: [# i
treatment. Previous reports of patients stopping treatment in complete molecular
2 E; u; \8 w zresponse have included only patients with a good response to imatinib. We
. w2 i0 c5 s. ~3 _describe three patients with stable complete molecular response on dasatinib
+ [% Y5 ]6 I) Otreatment following imatinib failure. Two of the three patients remain in
3 c8 r. n6 r0 [6 O8 q( icomplete molecular response more than 12 months after stopping dasatinib. In: E3 a5 T3 a9 C5 M
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
. t7 m+ p2 r) R: z' N# Z4 d* Ishow that the leukemic clone remains detectable, as we have previously shown in5 R, Q! ^+ Z2 h7 b3 }, r
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as! s6 W4 I' D2 {% C
the emergence of clonal T cell populations, were observed both in one patient
( U: }! p: A pwho relapsed and in one patient in remission. Our results suggest that the
+ u0 \# U+ H, I; e! Y6 i! c9 t+ `characteristics of complete molecular response on dasatinib treatment may be! q8 C6 D V" H1 Q% a$ ]
similar to that achieved with imatinib, at least in patients with adverse
# K/ F7 c: _5 [: u6 h; `disease features.
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