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。
. K: g; E0 |3 k! }9 A) v) I    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。

作者：来自澳大利亚
0 P0 Y! Z0 K$ h来源：Haematologica. 2011.8.9.
Dear Group,
6 o% L3 S: I! g7 ~' U, p1 }0 i
8 ]. I' v! F  f9 Z% m; e' DSome 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
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
, N. }* W& W$ t+ K. fremain 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.
: n6 o+ L2 M( O/ s  S
4 y$ R8 Z% |3 F4 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
  R" S" m$ _9 v* udifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.

Hopefully, the doctors will report on a larger study and long-term to see if the
8 B+ w& h, N: D; A$ Sresponse off Sprycel is sustained.
- Z& b/ i2 z( x' q; {/ O
2 p, I. q) J) tBest Wishes,
: F: t) Y8 y% v5 _  z3 MAnjana
; w! Y: h! d0 \% Q: I( M* N
) E& z% a) {, y" `

Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
6 G2 a+ R1 W, I* B# `2 d1 zSource
2 t7 E: d' ^; P. R0 U5 SAdelaide, Australia;

) r. \- k; h$ C: c5 D6 HAbstract
+ B  C0 i" M+ D  J' KPatients with chronic myeloid leukemia, treated with imatinib, who have a
  _+ m8 Y4 {* b7 `# H1 Odurable complete molecular response might remain in CMR after stopping
1 p5 N' L; W8 @3 d2 ?treatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
, m/ o$ q$ e9 O; Mdescribe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
- v0 w( v7 h7 x. n0 f3 N6 Z, bcomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
' Z5 F- v+ `; c( N* O* b" a# Yshow that the leukemic clone remains detectable, as we have previously shown in
  U4 l7 E7 y) k3 _! @( e4 \imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
/ y0 C+ v# r8 m8 q* d/ ^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
/ f% X5 a4 H9 E9 q; s, mcharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
0 {$ R- S" A4 ]1 T# wdisease features.
1 D6 F. m" [1 @) v( C7 q9 [) E

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。
# ], s- S7 \; \) d    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。

4 ^* @, c: f7 k6 u- n作者：来自法国STIM试验
( q' s* W' D, ]& ~1 J; M' ?+ Y6 \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