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。
# Z& }$ r3 P) P9 ]- W    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。

2 ^# b% w/ {! H( Q  [8 I$ C% b0 T作者：来自澳大利亚
, {8 G. Y4 W* P0 {* N8 x来源：Haematologica. 2011.8.9.
; G' K0 n. C' S: l0 Q6 j$ _Dear Group,

. J& Q/ ]; b; X4 ^8 I3 w3 L* i4 @$ g; RSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
, D0 s* N4 H% q  M) n* q% p: U8 ztherapies. 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- H$ m9 W& ~5 B# V9 a( f; kremain 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.
' P6 v2 {3 s% @$ f
  l( V5 I2 x# L+ N( H8 p0 r& ^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
5 H1 N* Q+ J/ T# Mdifferent from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
  g3 \9 o1 S' V# B
. I' \& a% D, nHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

, q9 {7 E& |0 B% r# u- DBest Wishes,
Anjana

. ]8 @! B( V; l3 S' r: I
, D, G/ @& x( n. y3 a9 s6 J. ?
* z6 u2 g' y5 v2 ?0 xHaematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
/ w0 o: a7 _6 udasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
( O- \. O$ o/ {: R: N) ISource
% j/ p/ G" n0 a( jAdelaide, Australia;

Abstract
4 H1 }( j. q; ?/ m  ?9 A0 y" lPatients with chronic myeloid leukemia, treated with imatinib, who have a
1 k, J/ p+ x+ X. Zdurable complete molecular response might remain in CMR after stopping
$ K( G5 m. X, U% @+ B% Ktreatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
; V/ D/ z9 }: z$ ]4 J% y7 y. v& v* B, Odescribe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
6 [5 ^3 \" u. Hcomplete 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
! g: a- O; R( {- ]- H# K2 I9 vimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
: J% i6 D: L# _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
" B, G( h2 C7 S; k- {characteristics of complete molecular response on dasatinib treatment may be
+ M" ~; d; `7 ~( ksimilar to that achieved with imatinib, at least in patients with adverse
3 n; R5 y! f9 q6 E9 {4 Mdisease features.

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. O4 R% r9 b: [8 c    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  n$ U2 p& m; g; S3 J3 n" G: c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