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。
. o# m( ~0 f/ r: _* } 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。& \ N& h; I, S& b5 h5 w2 i
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作者：来自澳大利亚# B% S' G' E9 r$ q, F+ L
来源：Haematologica. 2011.8.9.
( t8 s! ^# M3 e$ W0 `Dear Group,
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML. @0 ^5 U" t4 H( S, w6 O
therapies. Here is a report from Australia on 3 patients who went off Sprycel. X( J2 v% B9 [& {
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients0 m7 c1 t# P% n# D; l, s5 ?
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel6 O+ ^1 D/ \; x9 ?/ \3 S
does spike up the immune system so I hope more reports come out on this issue.. d8 U% [3 T0 z
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The remarkable news about Sprycel cessation is that all 3 patients had failed: l& V% ^/ `# c+ k" O, k M" n
Gleevec and Sprycel was their second TKI so they had resistant disease. This is7 F9 l. Y% M0 ]( {0 b+ D
different from the stopping Gleevec trial in France which only targets patients
* |4 y9 s% U' @7 H- n0 O( Bwho 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
4 p6 p3 B% p& j# ?( [3 tresponse off Sprycel is sustained.0 t. m5 L; [, r, Z* O
" I) b) P* I& CBest Wishes,
+ [# v# `4 g9 ~/ u# |Anjana
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Haematologica. 2011 Aug 9. [Epub ahead of print]5 e! M' S1 Q# t& O
Durable complete molecular remission of chronic myeloid leukemia following! i9 W4 E1 [$ |) ]8 v4 w
dasatinib cessation, despite adverse disease features.! W+ ]8 g }! l& [
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
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Adelaide, Australia;
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% l, l" s9 q5 P& n. h) d/ r8 w3 P) rAbstract# x: A4 F" W! ?8 w
Patients with chronic myeloid leukemia, treated with imatinib, who have a+ Y5 q+ y' Q' K; L3 ]1 D$ Q
durable complete molecular response might remain in CMR after stopping# U3 E( ?$ `; M5 Z% T7 J7 A
treatment. Previous reports of patients stopping treatment in complete molecular& O" E, L5 E+ `: U3 O
response have included only patients with a good response to imatinib. We+ W+ d* k# A. E: @
describe three patients with stable complete molecular response on dasatinib5 f/ z7 k+ ?, Z9 M+ G
treatment following imatinib failure. Two of the three patients remain in* F) C5 S/ n0 p) Q
complete molecular response more than 12 months after stopping dasatinib. In
* X6 t. K, u: P y% n' _: Fthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to9 y3 {4 H5 P7 ?1 c8 W! W- R% O2 p
show that the leukemic clone remains detectable, as we have previously shown in
. d5 k# S' I9 y( A3 Oimatinib-treated patients. Dasatinib-associated immunological phenomena, such as0 O, @5 {6 ^3 @) k: \; V
the emergence of clonal T cell populations, were observed both in one patient8 \0 v' U( p$ @0 z3 l: Z- } b
who relapsed and in one patient in remission. Our results suggest that the
# z' E( @( e7 B& a! Wcharacteristics of complete molecular response on dasatinib treatment may be. K# Y) ?: I( ^! a: b* V2 t! L4 [
similar to that achieved with imatinib, at least in patients with adverse' M) f5 a$ g1 Q, v- X9 E3 ^9 N) ^/ t
disease features.
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