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。
2 T1 I* H- t* e! P& y/ {( 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。
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, I( Q% [% D+ {+ m# I9 Y* E) W8 Y作者：来自澳大利亚1 U5 g: T8 ?2 O6 E" K9 E
来源：Haematologica. 2011.8.9.
! s3 A& g7 D9 C" v) B& cDear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
- h: G5 }% ^( utherapies. Here is a report from Australia on 3 patients who went off Sprycel$ v6 c" u* c& v; m6 U( e/ k3 U A
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients) O; i6 e; I* ~' M
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
0 X! U4 Q& o k3 o- A* kdoes spike up the immune system so I hope more reports come out on this issue.8 k2 I) Z8 |! }6 c
7 |/ P* p" ^) W0 eThe remarkable news about Sprycel cessation is that all 3 patients had failed0 E0 |/ A: g5 S
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
0 X; P3 }* Y" L7 ^5 o( b, p# k* Mdifferent from the stopping Gleevec trial in France which only targets patients, U6 N% ?4 s2 u
who have done well on Gleevec.. Z% O) ]4 I' v& N9 u5 m
/ l( `; K* j6 J; W- u- PHopefully, the doctors will report on a larger study and long-term to see if the; Z: j1 Q5 e* x0 c
response off Sprycel is sustained.
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' E+ _/ J% n" L3 z4 Z2 iBest Wishes,/ ]; }: h. f1 m: _: e
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
# E) r) Z/ c+ G0 B- }5 ~Durable complete molecular remission of chronic myeloid leukemia following
9 k% U3 m) a$ n+ \1 f9 I; c' ^dasatinib cessation, despite adverse disease features.1 F! @/ v, S2 a [# s' r, d, s5 [
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
; w- W8 O( O* n9 f3 ~ p/ v3 z9 \# ISource3 x+ f6 h7 W; D5 f3 a# _
Adelaide, Australia;8 e- [1 ]6 O+ e: n5 u' o
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Abstract6 q( N$ y, f9 I x
Patients with chronic myeloid leukemia, treated with imatinib, who have a
2 U3 d4 `# p8 H/ _" L% Z9 h* adurable complete molecular response might remain in CMR after stopping& ?; ^+ @! h2 [. s+ Z8 _
treatment. Previous reports of patients stopping treatment in complete molecular7 N! i9 z6 T# W: y' R
response have included only patients with a good response to imatinib. We
$ i r% _5 k- o2 D7 n- C" ^describe three patients with stable complete molecular response on dasatinib
( s1 Z7 i ^4 r" otreatment following imatinib failure. Two of the three patients remain in" C3 k3 _5 Y' X7 k
complete molecular response more than 12 months after stopping dasatinib. In6 a# U( A4 h" T
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to" F$ g# S. A/ r/ z. e4 X0 W
show that the leukemic clone remains detectable, as we have previously shown in% P+ a$ }, p1 J% r" q
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
& @3 E) m9 k. @1 I {the emergence of clonal T cell populations, were observed both in one patient$ m* E$ C- K# }& S, q- O" c+ _' L
who relapsed and in one patient in remission. Our results suggest that the! {( E9 d7 p) }- v/ Y. C& r$ K& l
characteristics of complete molecular response on dasatinib treatment may be
1 b! J$ u8 A$ c( ~3 esimilar to that achieved with imatinib, at least in patients with adverse
! c+ i3 F9 P# P4 ?disease features.
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