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。

; t$ y; B, o2 a" i作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
, @4 G$ @. _% A! w4 fDear Group,

Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
* l) {* L. f# f5 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
: J2 k4 K. a- ^; A) d/ t3 x( ldoes spike up the immune system so I hope more reports come out on this issue.

! C1 F3 f+ U* V. L& cThe 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
' t5 r6 R' x# q/ Rwho have done well on Gleevec.
4 {/ ]0 i3 G& |6 }. Q$ b( x9 V3 [
Hopefully, the doctors will report on a larger study and long-term to see if the
/ r( [" M( h5 {6 u4 ?& Bresponse off Sprycel is sustained.

" Z* P1 f; m  j/ Y8 e& V; PBest Wishes,
Anjana
0 [2 e: d. M( }3 J
- ^0 G# p' o$ o3 p+ y3 H0 ]

Haematologica. 2011 Aug 9. [Epub ahead of print]
) d/ e9 l! L; l6 F9 n6 mDurable complete molecular remission of chronic myeloid leukemia following
9 O. B7 z0 b4 f/ Q" zdasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
! W$ b8 I/ z# _6 ^" r$ u! FSource
: w/ ~% a  |  f6 A. X( }Adelaide, Australia;
) G) a1 f. O" M7 y$ R
Abstract
+ F; m, p; i% I/ D# G1 GPatients 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
response have included only patients with a good response to imatinib. We
: G: @) W7 b. w  R: X, cdescribe three patients with stable complete molecular response on dasatinib
6 y4 x1 o, u' ^) a- atreatment following imatinib failure. Two of the three patients remain in
. T7 C2 i; y) W; U5 fcomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
! S+ v. y/ d$ T- Q( u" kshow that the leukemic clone remains detectable, as we have previously shown in
: o' e9 \# _9 R; d7 e% eimatinib-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
5 b: _+ L% M: d2 Scharacteristics of complete molecular response on dasatinib treatment may be
  n, q5 b1 Q6 M2 M+ ~$ S% esimilar to that achieved with imatinib, at least in patients with adverse
% D8 _: b! Z1 b3 ]  tdisease features.
8 K- w- I1 [% r! Y! Z+ K

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。
. x# e& q1 {- [6 L! H
作者：来自法国STIM试验
) D# ~5 Y" M" S) x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