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。
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7 t% K* s5 }7 Z+ h作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
% I% v- @9 v/ s2 P" {! ?Dear Group,

Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
8 Z( |7 D' @6 s' Z9 I6 xtherapies. Here is a report from Australia on 3 patients who went off Sprycel
" G# M3 b" l& P- r  p. _* M% safter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
' b7 X! p) s9 v1 y* c+ zremain 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.

- X3 G( R" z8 C$ M( q& sThe remarkable news about Sprycel cessation is that all 3 patients had failed
8 I  n( j: l" O4 N( ]Gleevec and Sprycel was their second TKI so they had resistant disease. This is
different from the stopping Gleevec trial in France which only targets patients
; [( M! u) Y" Y3 b' R( ?' A8 nwho have done well on Gleevec.
0 u6 L  Y0 t: }* s9 y/ p7 I5 e
$ H0 ^' |  {0 P- J! m. G0 h% JHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

( O6 P4 O5 a+ d* i( n. ^6 U" NBest Wishes,
& R! M* P: Y5 Y9 |6 AAnjana

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+ k' D1 X& Q$ i( O
# _5 j5 D7 D0 E1 tHaematologica. 2011 Aug 9. [Epub ahead of print]
# _# C; z5 T* V+ XDurable complete molecular remission of chronic myeloid leukemia following
+ d, V& O/ @2 N2 Z* S9 cdasatinib cessation, despite adverse disease features.
0 z7 t9 z$ f( d4 L7 p' ZRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
Adelaide, Australia;

6 e2 G2 F9 C# X; m- {Abstract
) G) Q4 `+ h' L7 }Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
  f% p4 e3 o6 I9 G8 s/ W  m8 qdescribe three patients with stable complete molecular response on dasatinib
0 F0 k1 [/ d3 V* ztreatment following imatinib failure. Two of the three patients remain in
7 o: A' w* K" Z6 C2 @complete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
+ A1 r' A; _% D$ M5 k0 jshow that the leukemic clone remains detectable, as we have previously shown in
, k5 R  v# A7 u# simatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the 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
% d& i3 ?7 C$ Qcharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
! ^9 \7 f& W$ J4 `) _disease features.
+ d8 r( L7 S+ K" ?  k% |2 \) a: G

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
6 H$ F: ^5 ^( L' d' L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