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。
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作者：来自澳大利亚
6 ~$ Z( \4 G& o来源：Haematologica. 2011.8.9.
$ U( {2 y- I1 M( X/ KDear Group,

Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
6 R9 ~8 X* v5 ^therapies. Here is a report from Australia on 3 patients who went off Sprycel
$ y6 {5 q6 t% A( [: V- ^after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
3 u& p9 z+ i. K7 B' z& h1 R1 H# ?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.
8 s. _0 s+ f% V5 `
/ I) c# R' \' x' bThe 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
" _0 ~2 o3 z  T$ ~different from the stopping Gleevec trial in France which only targets patients
3 H4 V& J. i: A6 m! Wwho have done well on Gleevec.

  t4 ]1 F3 t+ z3 S$ O" qHopefully, the doctors will report on a larger study and long-term to see if the
3 R+ D( @( x. j' q0 M$ A9 Tresponse off Sprycel is sustained.
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Best Wishes,
Anjana

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Haematologica. 2011 Aug 9. [Epub ahead of print]
: |, D$ V5 B9 o/ fDurable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
- U6 n. z0 ^" _5 s6 Y; u- D8 PRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
3 x, q6 u* K0 U/ N) O$ X; \, {5 J4 @* P, ySource
8 b$ ^6 ~9 l7 c8 I! y8 q& a4 c: `Adelaide, Australia;

1 E) e: w4 ~* x  z5 }Abstract
9 O* {& m- O  ?' j1 lPatients 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
& V" z  N- p/ c3 |# Fresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
, E. P5 E1 Z/ s/ c8 o; itreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
( _7 ]9 v, d: b. a$ p# y' {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
5 ~# p, j, w, Y1 G! a' Vimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
% u# q' c7 z$ gthe emergence of clonal T cell populations, were observed both in one patient
" `! ~6 z- O. ?5 owho relapsed and in one patient in remission. Our results suggest that the
' I9 k# u$ f6 Z! Y% }4 {characteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
disease features.
( {; j5 Y% A" H) M; f) I# B6 o: z2 J

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。
9 e4 Y. f9 V1 a3 ~    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。
' _/ z4 H$ h# ~& A3 L& b0 P2 L) i    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。
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3 V4 i. p' v$ i7 o作者：来自法国STIM试验
6 V  T9 |7 t& S5 i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