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。
! Z( ]% p! ^) |( b 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9 x( ?8 F, J( s3 |
来源：Haematologica. 2011.8.9.) g0 S1 }. S( D
Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
& X9 Y4 |* O; Z/ b! P, Itherapies. Here is a report from Australia on 3 patients who went off Sprycel
/ p3 H. c' N' Q$ K1 }0 W wafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
$ V' s1 d/ V! y1 K+ \remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
. R6 D5 k" @ R: v# Z7 I+ m4 k2 Ndoes spike up the immune system so I hope more reports come out on this issue.
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( `3 o* p) y% qThe remarkable news about Sprycel cessation is that all 3 patients had failed
& x) n5 N, e8 _Gleevec and Sprycel was their second TKI so they had resistant disease. This is
7 w+ j6 R, N# |( {1 pdifferent from the stopping Gleevec trial in France which only targets patients
' J, h" _; C: I4 b* rwho have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the' q8 M- X3 a% p) l& q! u( p5 Y
response off Sprycel is sustained.
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: n/ r ~( W' ]% T& ?- q" l/ aBest Wishes,- } ]) B6 \, J, p; K/ W
Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print] S: H Q6 b- Q* _0 K6 x8 C) _
Durable complete molecular remission of chronic myeloid leukemia following* r8 }4 [1 j( m3 R; s* ]! b
dasatinib cessation, despite adverse disease features.
; j( c( g) \' Q! |' ]4 k* ]+ VRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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Adelaide, Australia;
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Abstract
+ B5 I. d" B3 U% XPatients with chronic myeloid leukemia, treated with imatinib, who have a
5 a! F q" R' M/ q6 [; ^0 R* `4 z0 T8 Mdurable complete molecular response might remain in CMR after stopping
6 I4 E6 \1 p' t t) x& m" [+ btreatment. Previous reports of patients stopping treatment in complete molecular
1 V7 s6 C* A1 _6 L1 p7 n7 _; Zresponse have included only patients with a good response to imatinib. We! h3 e, D# a1 \, _' c. y
describe three patients with stable complete molecular response on dasatinib
' j( p( J4 t1 j) ~$ ^" \! I3 s2 h: qtreatment following imatinib failure. Two of the three patients remain in
, {6 A ?! C2 o$ g0 y( F0 Fcomplete molecular response more than 12 months after stopping dasatinib. In3 J9 g* b6 D R, S" b. R4 Y
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to( \1 u0 k$ @/ }2 L- U
show that the leukemic clone remains detectable, as we have previously shown in
; y4 m. m& {6 }: V+ T8 Vimatinib-treated patients. Dasatinib-associated immunological phenomena, such as* F0 v3 i; P0 q6 V& s! v T3 x
the emergence of clonal T cell populations, were observed both in one patient
( X/ v1 l( ]) w# \# ]3 k! P/ qwho relapsed and in one patient in remission. Our results suggest that the
/ Q* X3 q0 L+ Zcharacteristics of complete molecular response on dasatinib treatment may be( A3 T. D; a O9 w4 [, X
similar to that achieved with imatinib, at least in patients with adverse
# \) D7 Q* k2 s8 B/ V0 vdisease features.+ v! J% C, b1 ]
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