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
* G/ V+ ~' d6 }+ \' K来源：Haematologica. 2011.8.9.
/ Q) _0 t9 _2 o1 F! `9 Z+ DDear Group,
, ~; ?& h4 {+ X) W1 @* s" ~
Some 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
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
does spike up the immune system so I hope more reports come out on this issue.

The remarkable news about Sprycel cessation is that all 3 patients had failed
* T" S2 M4 w2 f! X- F" m1 z. ?  kGleevec and Sprycel was their second TKI so they had resistant disease. This is
* {- a) s. K% L: _, x5 qdifferent from the stopping Gleevec trial in France which only targets patients
$ Z7 p) P1 i2 f5 L( P6 zwho have done well on Gleevec.

Hopefully, the doctors will report on a larger study and long-term to see if the
! Z% i3 P* ^# I* lresponse off Sprycel is sustained.

Best Wishes,
Anjana

+ Q1 ~3 P- q8 U2 g3 P3 H
$ _7 T' i8 K5 k- w4 D
$ J+ \; f. g8 ?8 xHaematologica. 2011 Aug 9. [Epub ahead of print]
4 Q$ x4 s6 W1 d3 {  ~8 \! W6 HDurable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
) W  g# J- ~% e( Y( J: O5 P8 {# gRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
% P" ~% E- F+ EAdelaide, Australia;

Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
  y" g. i& c) z5 B! X& }: ^durable complete molecular response might remain in CMR after stopping
9 U! w& U3 b$ m; j5 @7 |treatment. Previous reports of patients stopping treatment in complete molecular
3 T" k) S7 D$ W6 K% Q* @5 r6 xresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
# Q: V$ y# g; e4 g3 ecomplete molecular response more than 12 months after stopping dasatinib. In
9 t1 f6 i% E: Q4 k) l0 N8 b7 j9 sthese 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
8 x6 ^. V' N" Q5 e+ f) n+ ]6 D' Bimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
; a' v% ~; U7 b$ v. `5 U' ithe emergence of clonal T cell populations, were observed both in one patient
who relapsed and in one patient in remission. Our results suggest that the
8 u! T9 V0 t4 Y, p- |- q! v( G2 Pcharacteristics of complete molecular response on dasatinib treatment may be
( t0 I9 j& g/ W- l/ bsimilar to that achieved with imatinib, at least in patients with adverse
disease 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。
    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。

作者：来自法国STIM试验
% v+ b# u5 K( e9 y& u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