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。
% H- W- d, g8 P9 ]    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。

# y& Z+ t3 v& g1 h作者：来自澳大利亚
! A% k& d9 l1 {) L* P. N来源：Haematologica. 2011.8.9.
Dear Group,

Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
/ c, ^" H4 @7 L4 T9 o/ Gtherapies. 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
6 V, e# i# c4 h/ fremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
) A& S/ b& D- y1 G: Gdoes spike up the immune system so I hope more reports come out on this issue.

, ]! K6 B7 i. T& F9 I5 sThe remarkable news about Sprycel cessation is that all 3 patients had failed
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
; V, U+ n+ y1 V- i3 m4 n: C, Pwho have done well on Gleevec.
# {: {! [1 b! \% [4 s
3 x0 h! H9 a# N/ d* R4 jHopefully, the doctors will report on a larger study and long-term to see if the
; p4 L9 F6 i6 ~% oresponse off Sprycel is sustained.
% T; L+ ?. y+ W
Best Wishes,
Anjana
- U2 d; t! w# w" x) v, Q" Q


Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
' t% _/ ]% \" Z, ~; }2 W1 \dasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
, V: t: S5 G* u  @0 n, B! HAdelaide, Australia;
5 j) S. f6 e7 N/ s
Abstract
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
1 |) [# e* D) Presponse 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
; M2 q7 k/ x1 |; M& fcomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
' ~& E: I( C0 A# c8 t& n6 Nshow that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
5 \3 _- o' }9 O/ t8 C) D4 Mwho relapsed and in one patient in remission. Our results suggest that the
0 `& w2 u7 t$ h5 J7 Ucharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
" S6 P8 G- A4 Z6 xdisease features.
' y1 H! @, M0 R3 g( F# n  O

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。
8 |' \2 |1 y( q) ?# |' }4 ^    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。
) N) ]  R# \# a/ Z0 F, u0 `    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。
6 Q8 [1 J# [4 R- l) D5 n/ G# J' f
作者：来自法国STIM试验
! m) P$ u- v* i, h+ k( v) a2 ?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