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。
9 j" l+ y" n2 X7 A4 j    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' p! `7 u$ J: E作者：来自澳大利亚
, I8 D: F: x1 {& X# `0 p来源：Haematologica. 2011.8.9.
; m! \, N- T: o( S2 W) u+ ~Dear Group,

Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
" v! C+ G1 {; _. D. z- e  Etherapies. 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
2 |0 S$ \8 ]2 V0 ^9 ^2 V" Uremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
% g% d; L& r. E5 R- z5 Z+ u# O% M9 gdoes spike up the immune system so I hope more reports come out on this issue.
+ H" [+ d* }4 ^
The 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
  Z7 W/ K; `6 g9 Lwho have done well on Gleevec.

Hopefully, the doctors will report on a larger study and long-term to see if the
response off Sprycel is sustained.
. Z" [/ j' \. D' z' o" q0 k
2 S4 E7 H) Y: Q: a2 l" cBest Wishes,
Anjana
7 ]; q+ p% w& m5 ?" R# Q7 F5 s# N- ]
) R4 f, {% l" k. Q( ?  X( `; w6 _) p
. W' q5 I- Y, e9 P  w
Haematologica. 2011 Aug 9. [Epub ahead of print]
6 e) `; Q1 U2 f/ b/ O4 NDurable complete molecular remission of chronic myeloid leukemia following
3 M0 Q( Q1 R4 W' B$ [dasatinib cessation, despite adverse disease features.
3 m5 c  D$ C1 x1 R, yRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
4 b( e# ]- E% v5 d2 tSource
4 Z- Q: a% z1 c  W* uAdelaide, Australia;

Abstract
% {4 w; H& }- w, n7 FPatients 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
; C5 z9 ?$ q) m% L; g/ z" J$ ndescribe three patients with stable complete molecular response on dasatinib
* Y9 ?, a, ?- w  e. h% y/ ctreatment following imatinib failure. Two of the three patients remain in
, i1 S' M( N* G" Acomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
$ B( V4 H4 d# |, ~; I- x: y# O6 r: u! D- Ushow that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
the emergence of clonal T cell populations, were observed both in one patient
6 |) g7 m! L8 ]3 U6 Mwho relapsed and in one patient in remission. Our results suggest that the
" P1 }9 W" h; \. W8 `characteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
" F( c2 n( K( ^" [disease features.
: n, U  C) _; x& ^8 B: |2 P

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。

' ], e3 k) W: T+ C. z; f1 \5 g! j1 R作者：来自法国STIM试验
5 `8 K1 u$ _6 Q3 j2 M: v, B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