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。
  ~2 Y  x/ i8 o/ `6 m
作者：来自澳大利亚
5 Q) s& E6 F6 v0 z$ n: [来源：Haematologica. 2011.8.9.
Dear Group,
+ y% n3 e1 t1 P7 d2 A3 W/ S# z
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. 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
2 P7 K# G, [% d9 \$ j. S, premain 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.

" f! f5 c4 c/ A0 R2 H$ C& eThe 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
7 W' R! d  l$ R3 U- ?0 @different from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
4 M; y  \% v) U$ w$ \
Hopefully, the doctors will report on a larger study and long-term to see if the
! p9 `9 s) e/ Q; cresponse off Sprycel is sustained.

% _! s* y, D# ]/ ]# X% U3 LBest Wishes,
, ^! Q3 ?! w8 P/ P. g- uAnjana


( L& s8 X  D7 _2 M4 s
Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
' |' U2 q5 ?5 _, z4 O. r9 S3 IRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
. [7 ^' F4 K, hAdelaide, Australia;

Abstract
- l7 y, {) R  F8 DPatients 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
. y( A# e9 \3 ?/ j: l4 W! }# s! xresponse 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
/ q2 `1 O8 N- t5 I5 kcomplete 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
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
! |+ L* E" T1 v3 x3 s3 Y2 qthe emergence of clonal T cell populations, were observed both in one patient
8 G9 x9 R$ U% l( D0 Gwho relapsed and in one patient in remission. Our results suggest that the
; i7 G  N3 l! b  ]% w& ucharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
7 P/ W4 G/ j' q' S3 p) g# |disease features.
8 V- G0 p( O0 r0 U; D) _! E1 x

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。
0 z, j' s8 _& H. {    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。
5 f$ ~( v/ D6 `7 N    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。

: F1 ~6 a4 W; w3 b$ y( u8 @% S- t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