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。3 ~% v( t+ v, F$ F- {, B! T, |5 B
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。 v3 e4 `$ W* Q+ n2 N
5 C9 R" J! A5 m( M作者:来自澳大利亚$ z$ l. K5 x5 y
来源:Haematologica. 2011.8.9. y+ Y6 x5 S8 L4 o5 y; k m5 J6 h
Dear Group,8 b% X. h& b! J; k" H2 U y3 |
7 o2 q& J# U8 |5 r( wSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML* x" {+ r, K, D2 k; { s
therapies. Here is a report from Australia on 3 patients who went off Sprycel
1 D* X/ P" n' _3 p9 Q7 i6 Tafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
& ]- {1 u" M, {4 _5 I: n8 O" ~remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel6 ]; v; y" D; b" h( s# e5 U G
does spike up the immune system so I hope more reports come out on this issue.
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The remarkable news about Sprycel cessation is that all 3 patients had failed
+ l( h% p3 ]+ Q/ o7 E0 V. qGleevec and Sprycel was their second TKI so they had resistant disease. This is8 l+ l, ?1 }0 ^& c/ X- H, _
different from the stopping Gleevec trial in France which only targets patients
2 J7 ?& V* b+ n; |+ o. `. ^" i# Cwho have done well on Gleevec.: s$ d/ F* x8 m: `7 g! C8 Y
+ e* T$ T6 \2 r% f3 Z/ F. Z
Hopefully, the doctors will report on a larger study and long-term to see if the
: o/ o5 d$ Z( O2 d1 Iresponse off Sprycel is sustained.
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Best Wishes,
0 x5 i$ x- G" O& I& rAnjana- h5 V! O! w8 ~ Y% m% k9 \0 W/ |
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Haematologica. 2011 Aug 9. [Epub ahead of print]/ Y4 v0 M1 {! X- A
Durable complete molecular remission of chronic myeloid leukemia following) K7 M$ h0 k i; m
dasatinib cessation, despite adverse disease features.& `( {- N) q9 x+ G
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.! ?8 M* Y* P$ N. V6 ^5 ]/ Q+ r9 s
Source( T/ }& w$ I* f! A! [5 H* w: b9 ~! X
Adelaide, Australia;
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Abstract
+ M' f; c; n& c1 D GPatients with chronic myeloid leukemia, treated with imatinib, who have a
! w. F$ e9 ]& E7 i+ f" h- ddurable complete molecular response might remain in CMR after stopping
( X$ t# Z' ? Ntreatment. Previous reports of patients stopping treatment in complete molecular9 J; i8 o$ Y) {# ~! E+ }3 a% ?
response have included only patients with a good response to imatinib. We+ G7 N: T- B2 U, h- C. d/ @
describe three patients with stable complete molecular response on dasatinib$ N8 W0 U1 Y u" g% @7 |* l1 V
treatment following imatinib failure. Two of the three patients remain in; H9 w2 I% p6 M v2 S# f
complete molecular response more than 12 months after stopping dasatinib. In4 m% U2 ]) r+ p/ ?) L$ \4 t
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
3 H' E5 n7 \6 tshow that the leukemic clone remains detectable, as we have previously shown in
( v8 }! x4 z# Y' z$ x5 f0 i, Uimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
9 s5 C% A* A* S6 F2 K, {the emergence of clonal T cell populations, were observed both in one patient
0 l4 S* {# j0 p/ b- ~0 \% `5 \who relapsed and in one patient in remission. Our results suggest that the
1 j( O1 J% D: O5 ccharacteristics of complete molecular response on dasatinib treatment may be
$ e% u9 |% e" Hsimilar to that achieved with imatinib, at least in patients with adverse$ b" e9 E( M( h7 M* x
disease features.
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