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。
( J2 G1 U2 j" n6 R    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。

$ I% L: S! }5 c: n( Q作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,
+ _! B5 @4 E8 V! A; [7 X2 k9 p3 p$ C
! q& V0 ?% r/ u6 S7 c7 s- oSome 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
' i7 G! t" M* j  ~' S, Safter 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
does spike up the immune system so I hope more reports come out on this issue.
2 b1 y% j& M4 E: M, G7 F& v
The remarkable news about Sprycel cessation is that all 3 patients had failed
# r) ~5 K" I) h' `. X- l7 SGleevec and Sprycel was their second TKI so they had resistant disease. This is
' B; H1 ]4 T6 U- H- m: {1 v/ K. vdifferent from the stopping Gleevec trial in France which only targets patients
) Z0 N/ T. l. G) }0 ?6 a3 Wwho have done well on Gleevec.
) n5 A8 N) ^& r! d( ^$ Z, F
Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.

( Q" a0 J$ a6 bBest Wishes,
Anjana
" _& ~4 t$ F9 D( U" i


- d$ k0 s4 y# S8 g& rHaematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
0 S' v3 J. T1 E1 H, y. x( {dasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
) r- @! K3 C4 g  z( XSource
# d7 B. C) Z, p$ o! s2 f' l% e, eAdelaide, Australia;

! j! f; j% Q3 x: JAbstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
" d2 f' S9 R$ }1 I+ V0 N1 gtreatment. Previous reports of patients stopping treatment in complete molecular
( w& y% x8 d) p- e& {  i3 ?% Qresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
- E- a* f3 r( {treatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
+ g# w4 {6 m/ s# e7 jthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
5 j. q+ j2 ?& bshow that the leukemic clone remains detectable, as we have previously shown in
1 W& Y: S9 r9 V! P5 yimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
& H8 c0 F. P  P) e/ Ythe emergence of clonal T cell populations, were observed both in one patient
" t7 X7 ^' r' D+ ^0 ewho relapsed and in one patient in remission. Our results suggest that the
$ V& v3 b3 S- y& N! x/ ccharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
disease 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。
" c% ?0 Z( F: Z' u# s    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。
! g+ ?4 y* A9 `; \5 {
作者：来自法国STIM试验
  w3 R. }* w/ ^" S* U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