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。
+ E2 P% o. }1 A; v& B- S8 C 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。7 s) z. ?0 |7 v# z
6 t& c" h5 {2 s# ~! K作者:来自澳大利亚5 I7 z' k- ~* L8 ~3 {
来源:Haematologica. 2011.8.9.+ E/ C+ A/ y1 z
Dear Group,
. D' y+ U6 a( M3 ?
5 d4 o. ~* _5 v% o" k1 gSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML' e! l" b5 m' E$ X
therapies. Here is a report from Australia on 3 patients who went off Sprycel# c0 R6 t2 V; i2 p, l
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients8 d# r+ D) o) `* l2 a
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
6 F" M' k3 W) D. Jdoes spike up the immune system so I hope more reports come out on this issue.9 l8 Y ~- K- P
% m8 F6 v, b+ i0 ~9 i! c# A" L; r% g( aThe remarkable news about Sprycel cessation is that all 3 patients had failed
+ [% F$ U& l, c0 G; P B+ a% D, EGleevec and Sprycel was their second TKI so they had resistant disease. This is
3 ^! V1 s% Y8 V rdifferent from the stopping Gleevec trial in France which only targets patients
! ^: z, u7 k# R: P2 w% pwho have done well on Gleevec.
1 b4 U. T% u3 `7 {8 R1 l4 E
* |! ~' \! n: ^* V. jHopefully, the doctors will report on a larger study and long-term to see if the
+ ~8 K f6 d- Nresponse off Sprycel is sustained.4 B7 [$ U T4 L" ~& F5 Z; M
1 f0 m. p2 F! s% y: lBest Wishes,
) v8 B. y8 L0 M+ GAnjana" r. h: m+ y( }4 f8 X
6 X a1 G: t! A$ [7 P2 n3 A
1 C4 F9 Q# T' W! Z6 o. ^% e( f2 e1 i% D9 }
Haematologica. 2011 Aug 9. [Epub ahead of print]
9 r7 m( ?6 f; U, Q- U6 @2 N- @) V. MDurable complete molecular remission of chronic myeloid leukemia following
6 T& o/ s! C6 n/ q. S& l+ pdasatinib cessation, despite adverse disease features.6 T, |4 K* z% t( N, j. ^2 ?
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.) v5 d5 v. w. f, F; F
Source
" r+ }$ w( _; q9 r" i QAdelaide, Australia;2 b/ o2 @7 a' ?/ ^
& w: ~. R# f. k( g, {5 x
Abstract
. E7 X8 j8 Z3 @# ?; yPatients with chronic myeloid leukemia, treated with imatinib, who have a5 [" c& p+ M: C5 J6 c6 r% |
durable complete molecular response might remain in CMR after stopping
: D6 W' i; ~2 r2 N! `0 ytreatment. Previous reports of patients stopping treatment in complete molecular
) C' h: j5 b% T/ A, l c; Kresponse have included only patients with a good response to imatinib. We
5 t* h' o7 N" e$ ?' Gdescribe three patients with stable complete molecular response on dasatinib' h7 K- K4 I1 l7 u z0 P
treatment following imatinib failure. Two of the three patients remain in+ Z9 }& E7 k0 q2 o! b
complete molecular response more than 12 months after stopping dasatinib. In8 g1 d( j! B8 D3 [2 F$ _* k' I
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to" c9 D( C" J! b
show that the leukemic clone remains detectable, as we have previously shown in3 M1 q' \1 g1 D% D! @
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
; k7 M+ m/ ]9 v7 Q' dthe emergence of clonal T cell populations, were observed both in one patient
; {1 }1 ^8 \; U2 \4 {3 l' Qwho relapsed and in one patient in remission. Our results suggest that the0 v7 L G; a# S7 n Z4 ^% Q; z* E" A
characteristics of complete molecular response on dasatinib treatment may be) i0 N: a+ S+ n. ~6 B
similar to that achieved with imatinib, at least in patients with adverse( V1 K5 b; B6 I1 I( R3 n
disease features./ m# O& p* R; c5 c0 G1 ~& X
|