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。
: C" r7 c  z/ z, u, s0 c  t; x2 q: }) 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。

作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,

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
$ r5 S% W, }7 Q) W. V9 rremain 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.

The remarkable news about Sprycel cessation is that all 3 patients had failed
# e/ W8 P7 @) F; w8 }0 aGleevec 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
, m  M  y1 |+ bwho 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.

Best Wishes,
Anjana

2 h( S; D- d+ [# i* I# J* [

1 V2 V) ^- O# r3 g) F/ _# e' RHaematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
- W; i+ ~( i6 X' Z6 h# D( HRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
4 u/ M- V3 Y$ z; S' {  mSource
/ r" j/ v1 W' L# u) z2 |Adelaide, Australia;

! f& |- c/ Z8 q5 R! ?& o! \5 [Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
9 z/ ?9 A5 f7 X3 s( B5 }durable complete molecular response might remain in CMR after stopping
: E% k, k  a+ x$ O# Utreatment. Previous reports of patients stopping treatment in complete molecular
0 D1 d1 h2 }  ~; w5 M+ Cresponse have included only patients with a good response to imatinib. We
describe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
# q! a  I. G- ~7 J* |1 Z- @complete molecular response more than 12 months after stopping dasatinib. In
0 _' e4 p& t. L9 h& g! M9 M8 q# mthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
& q1 q8 y6 y3 d8 d; d+ Tshow 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
who relapsed and in one patient in remission. Our results suggest that the
/ q/ x6 Q+ U$ v2 J( h. Bcharacteristics of complete molecular response on dasatinib treatment may be
+ C$ \8 O! O$ b! p% usimilar to that achieved with imatinib, at least in patients with adverse
7 y$ b  F# b0 I8 M$ qdisease features.
# q: n) D3 }; z+ H- S

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。
6 y: u; y- O# G+ Y
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