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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2 W" n/ V: r9 s4 z5 V% ?( r作者：来自澳大利亚
" M3 T3 G: E: R来源：Haematologica. 2011.8.9.
Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
9 v& y! u+ P9 a' t: ttherapies. 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.
- M. O* b4 j" h7 c7 h
4 }; R5 e$ \& E4 s7 ~! P5 IThe 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
2 W) h/ N; [3 hdifferent from the stopping Gleevec trial in France which only targets patients
" _; G. s& S$ p1 ^% Q  l. G" H2 swho have done well on Gleevec.

. _, J$ o- d6 x& G$ iHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
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5 i; X+ [, C/ f# h$ QBest Wishes,
Anjana
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% y. V' m: ~* T+ x$ J6 a' `9 }Haematologica. 2011 Aug 9. [Epub ahead of print]
+ B% O+ h$ N4 ?% }6 FDurable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
Adelaide, Australia;
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9 q5 V- ?4 n2 pAbstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
3 {0 ^: _! E! x: t. N( e6 Kdurable 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
* W" q( a; ^. h4 f6 Ddescribe three patients with stable complete molecular response on dasatinib
# N* {0 U8 h) a- x, r+ S/ Jtreatment following imatinib failure. Two of the three patients remain in
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
show that the leukemic clone remains detectable, as we have previously shown in
( s& t6 O5 A' a$ m$ \) A- @/ Simatinib-treated patients. Dasatinib-associated immunological phenomena, such as
9 H5 @6 D1 `* k! X& w% ^* Nthe emergence of clonal T cell populations, were observed both in one patient
7 w8 o2 Q) e- mwho relapsed and in one patient in remission. Our results suggest that the
( R, g2 W" c: E, \8 A: {characteristics of complete molecular response on dasatinib treatment may be
* P) h! i9 o  C/ A: b5 Fsimilar to that achieved with imatinib, at least in patients with adverse
disease features.
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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 a0 k/ A5 H5 }/ X( Y    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。
* k" S2 K2 S3 k; \7 s0 W9 g# B    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
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