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。
; P# C, C% Z; G1 z, ]: g    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
% v" s: K- B* A$ X) ]2 w1 H$ H% Q来源：Haematologica. 2011.8.9.
6 e. R9 p0 K9 HDear Group,

: j( ~( e2 q" W% vSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
+ k! L6 S# s+ |5 ?8 d9 Ctherapies. Here is a report from Australia on 3 patients who went off Sprycel
; q% s5 K! b0 L' F: Wafter 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.
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% n" x2 o5 }0 UThe 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
5 _2 H9 [% \, j. T& [different from the stopping Gleevec trial in France which only targets patients
who have done well on Gleevec.
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Hopefully, the doctors will report on a larger study and long-term to see if the
0 S' M" X$ g% H7 ?9 g! ~response off Sprycel is sustained.
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Best Wishes,
  M* S+ [- Y& ?/ d' G, C, GAnjana
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0 B; H# {5 i% d( J( d/ cHaematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
8 w2 @. |7 g4 F  z5 ~# z; K3 o4 tdasatinib cessation, despite adverse disease features.
7 J1 }& c" n" a6 w5 f/ yRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
" L- A! _+ V$ g$ A: ]0 uSource
. ^/ j' e6 V& Z* S' dAdelaide, Australia;
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( [' c+ o2 r( B2 q: E: T& k+ sAbstract
/ r2 D- B# x' m+ E& J+ S+ L! APatients with chronic myeloid leukemia, treated with imatinib, who have a
. O4 G' R" {, f; F6 t* D+ T4 ]durable complete molecular response might remain in CMR after stopping
, D9 B9 o9 }' ]$ M! Ktreatment. Previous reports of patients stopping treatment in complete molecular
8 S6 Y- H' |1 x1 r0 cresponse have included only patients with a good response to imatinib. We
5 ~2 h. N4 B$ L/ w, U$ \describe three patients with stable complete molecular response on dasatinib
' d  Q( o7 h0 y& ptreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
5 Y* m: C: t" |7 \8 ]! Sthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
; y, U5 E8 ~! a1 T) ?; H0 bshow that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
4 u) d  y9 G3 R. @the emergence of clonal T cell populations, were observed both in one patient
/ @( i. h8 Q$ j3 }: W/ a0 t: Twho relapsed and in one patient in remission. Our results suggest that the
, m4 J- b; t0 u5 j7 z6 H; b+ Vcharacteristics of complete molecular response on dasatinib treatment may be
' A7 \8 c  F- L" `: Vsimilar 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。
    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。
7 {( p/ r2 L  f0 J( N: y    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。
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. i4 o4 k$ ~3 R7 f' R, ?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