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
来源：Haematologica. 2011.8.9.
% e( w+ X0 g- n+ v  v9 a$ C! pDear Group,
- \+ t# A( @* Q$ g4 d" y
$ q- i" ?( Z; u7 x1 k, D: ?9 u" USome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
1 O8 L+ `3 s: K( h( Q% N2 K! Gtherapies. 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
7 T! Z( r/ k9 Z6 C: P$ lremain 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.
, U0 a  x& F1 v6 X
- P8 q" P! P, P6 J. |, l) ~& @! gThe 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
( ?/ J3 n* U9 O$ X0 I0 \% ^different from the stopping Gleevec trial in France which only targets patients
+ i. g( _& ], v8 f& ywho have done well on Gleevec.
2 C# g9 K, C7 z! Q
* U, B: Z& T" ^# l1 zHopefully, the doctors will report on a larger study and long-term to see if the
( h6 O7 j7 z$ i2 l4 tresponse off Sprycel is sustained.

' n5 R$ a: n$ P3 aBest Wishes,
Anjana


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# O- k( n- p5 l: d4 P; aHaematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
5 l  N. J8 y# ~  o* H6 d9 G- A. wdasatinib cessation, despite adverse disease features.
5 y* X  W  M: ^& @- G% SRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
8 o  }; \9 _  R" q+ K& J' S- h0 JAdelaide, Australia;
$ ]7 p0 |" ~! J+ T3 s% g4 s. Y
Abstract
0 Q; S9 M. p; f5 UPatients with chronic myeloid leukemia, treated with imatinib, who have a
* ^. F6 A, J/ Z/ ]durable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
7 l3 l9 a" s; D6 wresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
+ M+ B) `8 m' ]* ^4 v2 a1 x6 b3 S' Y; Mtreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
' D* {. t% e# P3 Z6 kthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
8 W1 ~9 D- q1 R) ?show that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
0 N6 ?1 \( w* m; D& Z6 E& K5 kthe emergence of clonal T cell populations, were observed both in one patient
! ]2 T9 t* `- {6 ]* v, H7 f, kwho relapsed and in one patient in remission. Our results suggest that the
characteristics of complete molecular response on dasatinib treatment may be
% |0 ^, e% g6 `$ g" _# zsimilar to that achieved with imatinib, at least in patients with adverse
disease features.
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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。
, L( q) X8 [7 y, s. M' p& X    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。
# e/ @3 m2 v% x" M7 ]" i4 E- [    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。

! k) c$ e% T0 f; r6 p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