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。
9 v9 v9 D2 d7 R& }, A; [    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
6 w8 `3 f+ b4 c" F* w- R来源：Haematologica. 2011.8.9.
9 G# V' y9 [  ^$ k( i& W  [Dear Group,

; [- N- q# H, e& t# d7 MSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
: y! }! t8 e7 a0 Gtherapies. 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
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
3 R% q- _% U3 s7 p+ ]does spike up the immune system so I hope more reports come out on this issue.
& b5 r, Z6 N& S8 i' ~6 s
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
different from the stopping Gleevec trial in France which only targets patients
2 ?7 z: _4 i% |who have done well on Gleevec.

Hopefully, the doctors will report on a larger study and long-term to see if the
8 W7 `1 Y; X6 B0 m, Rresponse off Sprycel is sustained.

% P& ^3 S7 `# ^6 l) ^- O8 D. |Best Wishes,
Anjana


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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.
7 n; }7 a* e( D9 _' P; o1 qSource
' u4 m5 v7 }* I& ]Adelaide, Australia;

Abstract
. r" u. z  K, }8 VPatients with chronic myeloid leukemia, treated with imatinib, who have a
9 T; r5 F. u) d# E. D$ |8 cdurable complete molecular response might remain in CMR after stopping
treatment. Previous reports of patients stopping treatment in complete molecular
/ R; j' {1 o7 l9 n, ]# w3 presponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
" ]- R( y- q5 b( [* O# c$ d# `. Ttreatment following imatinib failure. Two of the three patients remain in
7 b: V* d% c1 Ocomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
! S9 I: l0 Q6 c; X+ a2 Kshow that the leukemic clone remains detectable, as we have previously shown in
' l1 y: h0 h6 u5 n) g* |0 ~imatinib-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
3 J/ z# b5 C* ycharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
disease features.
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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。
+ s' s8 ]1 k* f, }$ N    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。
$ u7 |" M* V* l) }) U; h8 i0 P    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。

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