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。
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; ?2 j/ z7 A' E8 H作者：来自澳大利亚
7 a. _, y' m! F来源：Haematologica. 2011.8.9.
Dear Group,

9 t; A, I# v7 O' VSome 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
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
$ G& p/ N: {; premain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
1 A3 Z, x6 u8 @  P( O* Odoes spike up the immune system so I hope more reports come out on this issue.
2 t6 x+ P) ]* @0 Z  r; J
, W0 t. t4 K4 Q- a& l6 ?# w2 BThe remarkable news about Sprycel cessation is that all 3 patients had failed
/ u5 ~; x1 V( F( m6 X% b  C, Z2 ^Gleevec and Sprycel was their second TKI so they had resistant disease. This is
& v# M7 ~7 `: f& udifferent from the stopping Gleevec trial in France which only targets patients
" j4 b$ G# ?# I! @; hwho have done well on Gleevec.

1 X/ L2 r, F$ m# FHopefully, the doctors will report on a larger study and long-term to see if the
5 I% p6 i  \( h/ g8 nresponse off Sprycel is sustained.
( O4 |2 {0 V. |, Y& p$ `( x% F
  H9 A0 h* y( B% l0 X; `% EBest Wishes,
Anjana
2 N8 k1 j4 r3 \1 D" }
# {& g' G! M7 t' u* y8 j$ k
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5 a  o9 v. k$ N4 F6 y  w5 w" PHaematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
& F! }( t2 p0 S" Q. R# hRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
* m; x, n) X1 a% z8 s* L* n  S; jSource
Adelaide, Australia;

Abstract
7 `& `  c' E# e" g4 w5 \" KPatients with chronic myeloid leukemia, treated with imatinib, who have a
durable complete molecular response might remain in CMR after stopping
9 ]6 O7 t9 J" W1 p% n, U' ]treatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
1 T9 ^4 M! L+ [1 t0 ~treatment following imatinib failure. Two of the three patients remain in
( j# o6 U+ f! l4 {# {4 Zcomplete molecular response more than 12 months after stopping dasatinib. In
$ s0 ]& V. k' V8 ~; S  B2 Uthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
1 y8 {0 |8 X+ Dshow that the leukemic clone remains detectable, as we have previously shown in
' K  A5 f) f0 r3 Z6 wimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
; w7 W! E0 F; X# \/ Twho relapsed and in one patient in remission. Our results suggest that the
characteristics of complete molecular response on dasatinib treatment may be
' X: D0 S4 C; P/ N2 ?: Y( fsimilar to that achieved with imatinib, at least in patients with adverse
disease features.
/ e# K/ {8 M+ 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。

作者：来自法国STIM试验
7 J- X+ Q% O5 T, E$ F  R$ ^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