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。
0 T0 x Y0 f# ~8 A- H; { 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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1 L( E% x& k) |3 m; O0 A$ |作者：来自澳大利亚! J0 u6 T& {' B
来源：Haematologica. 2011.8.9.6 i1 L) M/ t5 a; y
Dear Group,# q! d( Q8 E' C! ~0 e; Z
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Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML& b- Z6 e( s5 g' e
therapies. Here is a report from Australia on 3 patients who went off Sprycel# M: i1 n5 a* i! q
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
( \8 T+ u4 P' c1 i5 C1 w7 L5 fremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
+ {/ _$ i: C/ [0 }5 V; qdoes spike up the immune system so I hope more reports come out on this issue.
7 p( v n4 c n1 @
. W2 ^! e$ o$ x7 Y1 S* _- sThe remarkable news about Sprycel cessation is that all 3 patients had failed
! B" z1 I# N: M2 i( b. uGleevec and Sprycel was their second TKI so they had resistant disease. This is
1 S. b% o! m0 \7 K3 w: A, }% Q: Jdifferent from the stopping Gleevec trial in France which only targets patients5 m2 B0 q: l+ ~" j3 ]/ t1 l) C
who 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; C; n4 c9 r; ?# I+ S4 v+ s# M
response off Sprycel is sustained.. D& r! U$ j# l1 d; j, j
4 t2 V! C! X6 {" C& N( B; ~Best Wishes,/ Q( \% \$ m! w$ |4 V
Anjana
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- ?2 l6 D0 x$ YHaematologica. 2011 Aug 9. [Epub ahead of print]
* j$ U% P9 X& m( u8 D- n, p1 TDurable complete molecular remission of chronic myeloid leukemia following
% [3 y2 _8 m: L o. U% H1 {dasatinib cessation, despite adverse disease features.
/ X1 s- j% K3 K9 {- b+ w+ RRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
; e. Z; Y" n( A6 qSource
* g4 Q$ q Z+ V0 w! ]$ x9 YAdelaide, Australia;
* ~, G j) u2 r: e4 z8 ]" ?# ?6 l. d$ R, k" E. Z
Abstract
4 u+ c" u4 L4 ^* `2 fPatients with chronic myeloid leukemia, treated with imatinib, who have a; L) m. e0 Q6 Y* |. ^$ B1 w
durable complete molecular response might remain in CMR after stopping
" t! t2 `& F( {- p% w7 \treatment. Previous reports of patients stopping treatment in complete molecular
( Q7 U: o- y; Iresponse have included only patients with a good response to imatinib. We c( c3 k! H0 Z7 b4 r
describe three patients with stable complete molecular response on dasatinib: n5 C$ g t3 e3 h) [ {* C$ p
treatment following imatinib failure. Two of the three patients remain in
, M5 J: N) K$ Bcomplete molecular response more than 12 months after stopping dasatinib. In+ V% E/ w6 W0 ~1 M
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
: }5 n! E& G; c6 Cshow that the leukemic clone remains detectable, as we have previously shown in
+ X8 C* s4 w# Qimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
) p8 z0 ?" M! m$ x" `/ t' v$ x/ M& ~the emergence of clonal T cell populations, were observed both in one patient
1 c$ Z3 G( L/ H; j9 `2 owho relapsed and in one patient in remission. Our results suggest that the
* l# s: Z, X( \, U0 y* A( ?, L! q" Pcharacteristics of complete molecular response on dasatinib treatment may be: o$ Y2 q+ a0 H0 L7 {
similar to that achieved with imatinib, at least in patients with adverse
; ?/ ]4 c9 d$ Adisease features.6 z/ V# _# {1 x- L
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