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。
# x) |' Z' U& D) c3 H4 H5 d 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。3 ~, S) @! \* D3 Q( N: C& U
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作者：来自澳大利亚0 M' l) z7 V3 z* v! C2 U4 y: d' S
来源：Haematologica. 2011.8.9.
0 e* U# f* @. g9 n- o# s lDear Group,
8 D7 r$ A, k# W7 F5 G, z/ U3 w% B- D
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML% V8 r$ Q# V/ Y2 B0 P% i
therapies. Here is a report from Australia on 3 patients who went off Sprycel
; }5 Z, n8 D$ q9 aafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
. H! _" c3 C B' w+ [$ xremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel. ], t9 d8 e" f0 V# `/ {
does spike up the immune system so I hope more reports come out on this issue.* ~0 _# ]4 z' O/ I* J$ V
4 ]$ B m% n4 x* d: A' V0 |# ^The remarkable news about Sprycel cessation is that all 3 patients had failed$ I8 u G+ ^0 M2 W, n. z' ^
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
: }; X v" H) `( adifferent from the stopping Gleevec trial in France which only targets patients
7 K k) l8 C5 D# ~/ }! Kwho have done well on Gleevec.
+ j2 |- b5 z) h" _2 Y2 H: e$ j
& H9 L7 F, ]0 M* J3 {Hopefully, the doctors will report on a larger study and long-term to see if the/ V" G0 v" p. b( P5 M& h( O
response off Sprycel is sustained.
# L# m0 n0 a l+ s% ^) Z; t' o& _9 W8 k4 h
Best Wishes,! q! H2 K1 H7 X
Anjana+ H6 `" ?* Y+ ]! `- V5 u
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Haematologica. 2011 Aug 9. [Epub ahead of print]6 r, X2 H' t5 I5 `5 b
Durable complete molecular remission of chronic myeloid leukemia following3 h( l$ D0 ?- e5 S# t3 A% ^
dasatinib cessation, despite adverse disease features.- ? I: C" y n& C: w! q& D9 d
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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Adelaide, Australia;
6 |) |! y! L9 V. \* O) i2 |. \" ?; X8 f% m) e5 b0 c
Abstract# R/ j4 L8 A7 ?1 D& \7 M' n
Patients with chronic myeloid leukemia, treated with imatinib, who have a
! o: J0 h; d; m4 Z) M2 A( ~8 N* mdurable complete molecular response might remain in CMR after stopping: V2 |, E* M7 v9 d1 l
treatment. Previous reports of patients stopping treatment in complete molecular
) _) h8 N: q- W9 P& ?2 e6 Yresponse have included only patients with a good response to imatinib. We
3 b) h# a" t) P/ {describe three patients with stable complete molecular response on dasatinib
( z2 N4 F2 f9 {# F% ~( Ytreatment following imatinib failure. Two of the three patients remain in" y% \) X8 L+ t% e5 S! l; J2 C
complete molecular response more than 12 months after stopping dasatinib. In5 _0 y, ]* y. f: @5 N
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to% W9 u O- M: p; E( N# p6 r
show that the leukemic clone remains detectable, as we have previously shown in
. V' n. J4 N9 m- ?% Nimatinib-treated patients. Dasatinib-associated immunological phenomena, such as |7 ]7 P, ~% R% v4 A- b
the emergence of clonal T cell populations, were observed both in one patient X) a) g6 q2 H' F* W+ S$ s) m2 o7 W
who relapsed and in one patient in remission. Our results suggest that the
8 P$ S- Y$ Y, d$ X# [$ Zcharacteristics of complete molecular response on dasatinib treatment may be! q' [! n r$ T+ W$ R: c, ?% w8 F
similar to that achieved with imatinib, at least in patients with adverse; B; f* M1 x. a
disease features.9 G, t; Z; K* R% E5 k, B
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