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。
  L9 C( }1 h3 D4 M& }: ?    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。

: X% U1 ^+ [7 t9 C: g- u; N' N作者：来自澳大利亚
) ^4 K' M3 Q5 D来源：Haematologica. 2011.8.9.
Dear Group,

Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
( d. Z5 {0 U7 O  n# A- Q6 D  ^" ytherapies. Here is a report from Australia on 3 patients who went off Sprycel
- o+ H9 ^' K9 D5 L5 rafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
2 J* b; B3 H: u, v  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.
( J. C+ O+ L; @: A  X+ p
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
* [: p3 A6 Q4 v( \+ Z8 Y3 k- Kdifferent 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
1 Q# ]& g& ~; F9 u% [response off Sprycel is sustained.
7 B% _# a, k1 Y' b
Best Wishes,
Anjana

, G6 w5 ~8 S4 T/ H7 }
, P; n+ S0 R& i1 d
Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
' y* ?( R# O0 p! E* R3 X, M" @- Ddasatinib cessation, despite adverse disease features.
( s! R' g$ H# W6 t" _1 W& |4 ?Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
2 M+ {- ^0 o* |* U' hSource
. }. |2 z- a+ B5 YAdelaide, Australia;
6 B) B3 U, {* l8 @
Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
" L; e9 _% a. @- G) zresponse have included only patients with a good response to imatinib. We
( z# q; g/ b% L' B9 a0 qdescribe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
- H3 }: j) K, E; X3 W8 K0 ncomplete molecular response more than 12 months after stopping dasatinib. In
. y. f8 B+ m* z5 D( Y5 ~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
1 D0 M- N" d$ E; Qimatinib-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
  o# m+ F' m+ e7 u4 ?characteristics of complete molecular response on dasatinib treatment may be
0 S1 [( m7 r, Isimilar to that achieved with imatinib, at least in patients with adverse
disease features.
8 `( {7 F. q! C) K0 N, w$ s5 u) 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。
8 B/ u. ~% k, c6 @' l, k; T    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。
; h! D0 `  }+ T& R& i! E' u4 m
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