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。

作者：来自澳大利亚
$ e$ d# a; D8 A- J, z/ v来源：Haematologica. 2011.8.9.
Dear Group,

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
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.
+ L/ L% M$ k8 n$ w3 A
6 ^$ R1 n0 `# E9 R8 r$ J& ~9 hThe 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
( P" |& Z2 f4 j, H6 B2 {3 y* tdifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.

. C2 _  S$ v) T" UHopefully, the doctors will report on a larger study and long-term to see if the
& d" u. {- P, ~0 xresponse off Sprycel is sustained.
; K7 V  R/ \7 F% `% B8 @( H
Best Wishes,
1 \: e% h( m" U3 TAnjana


' T5 t' Y, a. ^: [- _- l8 h' f# F
/ s) x, Z/ d2 K8 ^! pHaematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
/ h( r6 |8 F* vdasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
- Z, j& {( r. P! PAdelaide, Australia;

% E) {# ]) P' G0 l5 ~) jAbstract
7 S$ C7 a% S0 _7 U5 QPatients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
. x" L$ W6 \1 M, a/ V; I6 X' [treatment. Previous reports of patients stopping treatment in complete molecular
4 I5 ]: a* T& G0 C! Qresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
2 b! b) Y* i$ W- g; l3 m- otreatment following imatinib failure. Two of the three patients remain in
- }8 n; {3 q% Wcomplete molecular response more than 12 months after stopping dasatinib. In
1 {: i& L3 l4 m3 F7 c! ]/ mthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
. {) x3 U, H: u$ f5 w. ?show that the leukemic clone remains detectable, as we have previously shown in
+ q3 B# Z( G0 K# A5 h4 Vimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
* M7 R* Q8 y! t$ X# ~5 ^* pwho relapsed and in one patient in remission. Our results suggest that the
characteristics of complete molecular response on dasatinib treatment may be
! e$ |0 S* q  h/ m; z& K; V3 ssimilar to that achieved with imatinib, at least in patients with adverse
; b( b+ y( |) _! s. e( K( jdisease features.

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。
/ o: c( t/ W% f. L1 |    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。

* u3 y2 [/ r3 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