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.
Dear Group,
% _4 o6 z+ u2 B9 ?
! _5 o" G5 a, f5 m! a$ \2 HSome 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
" t7 _1 L/ @1 J9 zafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
8 B5 ?6 y5 Y! gremain 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.

The 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
+ r( F$ w) O% g$ K1 b2 s- Ldifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
) s: j; S1 t+ r! `5 [8 V
5 o: M1 L: w; |. a1 DHopefully, the doctors will report on a larger study and long-term to see if the
$ G% r8 Y7 \1 \6 S$ Nresponse off Sprycel is sustained.

! @8 @( b: Z9 r4 H5 ]. M- G- v+ ]" bBest Wishes,
Anjana



1 u! H; x. B* x- a7 LHaematologica. 2011 Aug 9. [Epub ahead of print]
( X8 f# F2 N& f" \/ f$ HDurable complete molecular remission of chronic myeloid leukemia following
! w8 z: O; k, ^2 Idasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
8 q! F5 f. d0 {- Z  d+ @3 NSource
/ I2 b1 {% `# X- |% HAdelaide, Australia;
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Abstract
; ]" p& E8 [2 ?7 n6 Q* f8 ^. HPatients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
5 u. `. ^0 E3 n- h& Otreatment. Previous reports of patients stopping treatment in complete molecular
% h" Z! q, V/ r- L" Sresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
9 y. ~  t! E! R9 \$ ?$ D/ O+ Z# otreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
0 u0 S3 u* ^9 b, ^, I' V0 ?7 Vthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
* P( [, Z  D) }# W# ]. ^show that the leukemic clone remains detectable, as we have previously shown in
8 Z1 b$ U( x0 q0 X& dimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
8 B: z; C! d9 n$ }' _) h' K' bthe emergence of clonal T cell populations, were observed both in one patient
& S+ p& ]+ K( s. v( \, o" W5 ~4 O! ?who relapsed and in one patient in remission. Our results suggest that the
9 b! c+ R! u- K% X% m. Q, g8 Acharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
8 n' [" B- m- Z9 c$ Y# L- cdisease features.
- T0 |9 E! E: ~; v! x6 F

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。
5 a4 ]' M' [$ W+ |6 `    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。

- ~2 j6 P, A# S; G# K作者：来自法国STIM试验
6 q0 e7 f! H1 H6 E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