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。
9 U* E& m1 `. X9 g4 M 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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作者：来自澳大利亚+ ~' [% b: w0 X F) Q4 {
来源：Haematologica. 2011.8.9.
/ h& N/ F ?* u1 g; |& s4 ]8 KDear Group,& y( E+ P% U$ S5 b& z
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML1 y2 v$ l( G: X0 r d- b) g
therapies. Here is a report from Australia on 3 patients who went off Sprycel7 u4 C: _7 C. @/ \
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
0 V5 ^9 }9 j& M) ^! K. U6 f# aremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel) e3 w6 E1 I0 n2 V9 B
does spike up the immune system so I hope more reports come out on this issue.2 I: D% v0 D' L* U8 X
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The remarkable news about Sprycel cessation is that all 3 patients had failed6 B; Q; Z1 i6 |* L1 B$ l' N i
Gleevec and Sprycel was their second TKI so they had resistant disease. This is8 C: G h9 W' C# c* V- a* b2 X
different from the stopping Gleevec trial in France which only targets patients
2 _! | i8 ^, F1 `who have done well on Gleevec." q! _; X1 t6 v! d, _; b
5 S ?8 W0 H8 ]( tHopefully, the doctors will report on a larger study and long-term to see if the% ?8 @" H& A. O3 K" z1 k2 R
response off Sprycel is sustained.( f9 I4 F+ ^' l, u
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Best Wishes,
( Z8 t6 y4 D$ U2 ZAnjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]
$ F" {: v- M! [: T- { S- a lDurable complete molecular remission of chronic myeloid leukemia following
( I3 p! }9 y. r( |( }dasatinib cessation, despite adverse disease features.7 b g- U+ T( y* Z5 h. h
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
9 {: K2 j7 X% sSource
b/ J. f# w& l) J& G, c# x: E3 f% lAdelaide, Australia;
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Abstract Y! j# n: I& d/ e5 H" z
Patients with chronic myeloid leukemia, treated with imatinib, who have a0 m! |2 y4 U* a+ K. K0 k2 U9 z8 O
durable complete molecular response might remain in CMR after stopping
. J- U a7 C8 rtreatment. Previous reports of patients stopping treatment in complete molecular
3 }1 |/ Q8 d, l: G; v8 J3 s) G: }& eresponse have included only patients with a good response to imatinib. We _# H7 [' K8 Q9 D1 D
describe three patients with stable complete molecular response on dasatinib! a1 M- K: M' D
treatment following imatinib failure. Two of the three patients remain in: `" H& N7 r t) s+ H. Y
complete molecular response more than 12 months after stopping dasatinib. In3 i. W7 J: U4 B* ^+ J0 F' z
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
' n) x7 L0 b. O! B4 Dshow that the leukemic clone remains detectable, as we have previously shown in
/ J( C- o @9 J7 e. |" Wimatinib-treated patients. Dasatinib-associated immunological phenomena, such as9 t* U/ g7 ^+ g a
the emergence of clonal T cell populations, were observed both in one patient2 M I0 Z% Y: ~* b4 P) b! k' i
who relapsed and in one patient in remission. Our results suggest that the& [3 z$ \; m% v) D2 s& }# q
characteristics of complete molecular response on dasatinib treatment may be
" v* s$ W, f, r" q! N+ l5 N0 u3 ^similar to that achieved with imatinib, at least in patients with adverse
+ y5 C5 Q+ `1 i4 q& l4 Xdisease features.2 [% w! J2 F- v7 `* \
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