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! G$ g' {- J% R  G    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 h& x- h; I2 X3 t* Y# Y6 C
作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,

Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
9 }% F+ F% L8 l$ ?& n1 [therapies. Here is a report from Australia on 3 patients who went off Sprycel
# n! w6 v7 b7 Z: {2 safter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
  v  S- E- K/ W. {/ r9 j# s, |% mremain 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$ N: g5 [" V- r  i
The 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
" e) d/ {! H  R' pdifferent from the stopping Gleevec trial in France which only targets patients
4 O7 x3 a: r) |/ u% W, N, Rwho have done well on Gleevec.

Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
' H# l8 W4 ^( c( X
Best Wishes,
  E/ J; K9 D) nAnjana
5 ~! R" D) I) }* @: l
0 S5 b% B/ `( d" X# |- ~5 ?

: U' l! Q% @3 w# a; i2 ~Haematologica. 2011 Aug 9. [Epub ahead of print]
# u$ E1 ^" g+ Y8 _; `! A" `Durable complete molecular remission of chronic myeloid leukemia following
  s8 ]5 a& B' m& h3 adasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
Adelaide, Australia;

Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
# Q% f4 N0 L; S; x' Sdurable 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
describe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
) |. u2 a, G) e- c, u  jcomplete molecular response more than 12 months after stopping dasatinib. In
( A) t  ?3 `: k. l7 C% vthese 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
the emergence of clonal T cell populations, were observed both in one patient
who relapsed and in one patient in remission. Our results suggest that the
0 V" \. p4 |0 p: n. t. Acharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
disease features.
+ c; M% z- }+ U8 b# M3 ]

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。
    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。
    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。

5 ~: S" K5 ?" w0 T$ k3 \0 S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