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。
7 F% \2 H. b( k8 r+ ^, N- D
作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,
2 }4 g. t% p1 k7 U
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
* H( V% D: P2 p2 p& atherapies. Here is a report from Australia on 3 patients who went off Sprycel
9 ]6 g5 V3 {- q; e- @after 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
& O: h, p8 m8 n, ?) x( n% `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
9 r1 [. Y- o. {; g& g% E' i/ Rdifferent from the stopping Gleevec trial in France which only targets patients
8 ]+ k+ U; t: vwho have done well on Gleevec.
  b/ n) y+ c$ m
Hopefully, the doctors will report on a larger study and long-term to see if the
, P+ D$ V7 u  L" H+ Y& T7 dresponse off Sprycel is sustained.
# T( P. n% Z5 I. X1 w: B5 e( h
0 t( m' S, O. eBest Wishes,
Anjana
9 z  r2 T% N7 d! `


. V- {5 Q% K& F$ |: SHaematologica. 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.
$ |! ?% a" o3 [& S: |6 i. USource
* G6 Y% T. o& f& d. c4 ^# ]& X. QAdelaide, Australia;
9 W7 ^1 q0 x" d  ^% z; @9 j5 p- e
Abstract
$ I: Q! {7 P* DPatients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
9 h5 [2 S% S1 P/ W3 I3 Htreatment. Previous reports of patients stopping treatment in complete molecular
1 V2 y' {8 w: r9 W3 o7 l. `$ c) l5 |response have included only patients with a good response to imatinib. We
2 X- \2 E$ X4 @9 Kdescribe three patients with stable complete molecular response on dasatinib
7 ^. L, k0 Q# n5 Q5 c2 gtreatment following imatinib failure. Two of the three patients remain in
5 C2 K% x, D8 Z% M0 `complete molecular response more than 12 months after stopping dasatinib. In
these 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
- B5 b/ n! ^. l# gimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
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
& P) e* P+ _6 i" Ycharacteristics of complete molecular response on dasatinib treatment may be
" Y7 E7 p+ ]8 X/ U+ \similar to that achieved with imatinib, at least in patients with adverse
4 `2 C" F* s" b% t: Jdisease features.
& n* s* |# W1 I  R' `' o

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。
    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 C, u0 G6 o& R- o, T
7 r, J* z  a+ L  m' N作者：来自法国STIM试验
& s% J" C; Q$ K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