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。
8 P9 A6 W. R6 `    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。

作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,
) P& @; r! s% k- i  \7 j
Some 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
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
. {( \) ?4 u& J$ jdoes spike up the immune system so I hope more reports come out on this issue.
+ @! m/ l, f9 w3 T4 l5 [
The remarkable news about Sprycel cessation is that all 3 patients had failed
3 n7 y3 P( k, i# O. N2 TGleevec and Sprycel was their second TKI so they had resistant disease. This is
6 m* ]$ g' h, ^( i4 A) Udifferent from the stopping Gleevec trial in France which only targets patients
' K8 j8 J' D0 z1 I" n3 U* G+ C7 Cwho have done well on Gleevec.
3 g  H. G4 Y! k1 ?1 v: z/ |
; v0 N" [9 E2 ^8 H# RHopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
" t: ~7 p* P/ }4 X8 I
1 D6 I) S5 _( V% \: UBest Wishes,
% k2 \8 R; K8 l0 W- `! g% t' U' r+ _Anjana
& D, F; g) Y' I+ K# `9 G# k
" m- m# B. E( U$ C* x

Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
$ \1 c4 c" f  u5 q( x9 P0 mdasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
1 a  q+ t  {9 w/ G% p0 W& CSource
; t; E9 d; m- ]3 e2 HAdelaide, Australia;

& t5 P! i# X4 o" \$ tAbstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
* Q+ O* S! L' y/ Q0 U0 Z: l. Edurable complete molecular response might remain in CMR after stopping
3 t9 i: {& l1 b1 [* X9 _+ l, Vtreatment. Previous reports of patients stopping treatment in complete molecular
/ N$ Z2 ~# s6 h  ^7 [1 z% ~4 \( Xresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
% s6 i1 H8 L1 u1 Z" atreatment following imatinib failure. Two of the three patients remain in
" c- h& j/ W# a: P( i% g8 f5 ?8 Lcomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
& m( W7 k+ Z, w2 h/ l, F  Gshow that the leukemic clone remains detectable, as we have previously shown in
5 b3 a* {6 K, k7 ?$ j- ]* simatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
; \) J. m. ]; f! ]+ Jwho relapsed and in one patient in remission. Our results suggest that the
  R; j6 ~4 S  i1 i5 @6 Echaracteristics of complete molecular response on dasatinib treatment may be
7 u+ M! x: B" j6 B9 U) Ksimilar 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。
# u3 \& X3 \( i% Y9 Z" }5 S& o# 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。
    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。

# [& s5 x6 K- K作者：来自法国STIM试验
: t+ ^; @( I( `% z1 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