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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% }, n+ P) C, r! K8 R& }作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
: ^: R, N% E/ W0 s6 j2 h8 ]2 P3 oDear Group,
1 {! T& F7 a6 y: }! M
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
3 Y) ]3 r2 X2 z% K1 d2 a. Wafter 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
& U  f% j5 C5 I$ M. Adoes spike up the immune system so I hope more reports come out on this issue.

% T# r# ^7 j7 O* y& yThe 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
) e2 x' v1 Y& Odifferent from the stopping Gleevec trial in France which only targets patients
# q5 o4 h( i+ p2 U: y/ s) Kwho have done well on Gleevec.

# [4 D9 D6 t9 k* {' ^. THopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

Best Wishes,
- K8 B8 [9 u7 |Anjana

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Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
! Q0 j; ~' \+ lRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
Source
Adelaide, Australia;
/ ^8 l; `' c4 F! x) g( s
Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
/ `8 d0 U# @( ~9 Y5 ktreatment. Previous reports of patients stopping treatment in complete molecular
% k& x9 e; t, Z8 k6 Z/ k+ X" hresponse have included only patients with a good response to imatinib. We
: L) r2 g5 K- m% R! }describe three patients with stable complete molecular response on dasatinib
" y' H. w$ i1 }( |treatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
$ l9 @" A0 R/ S; v% qthese 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
. r& i" C# U2 x  [- kimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
6 \5 [! |8 s+ x/ s4 T  L7 {the emergence of clonal T cell populations, were observed both in one patient
who relapsed and in one patient in remission. Our results suggest that the
! H6 |, o: `$ V! K$ P& Acharacteristics of complete molecular response on dasatinib treatment may be
4 v+ I/ |6 e# d/ n- H" ?similar to that achieved with imatinib, at least in patients with adverse
8 Y& Z0 ^. w; m! k4 ?+ E1 ]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。
    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。
) Q& q# {1 F5 N, i* Q    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。

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