Dasatinib cessation after deep molecular response exceeding 2 years and natural killer cell transition during dasatinib consolidation
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- 森田, 智視
- Department of Hematology, Ome Municipal General Hospital
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- Nakaseko, Chiaki
- Department of Hematology, Chiba University Hospital
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- Nishiwaki, Kaichi
- Division of Clinical Oncology and Hematology, Department of Internal Medicine, Jikei University School of Medicine
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- Yoshida, Chikashi
- Department of Hematology, National Hospital Organization, Mito Medical Center
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- Ohashi, Kazuteru
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center
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- Takezako, Naoki
- Department of Hematology, National Hospital Organization Disaster Medical Center
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- Takano, Hina
- Department of Hematology, Musashino Red Cross Hospital
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- Kouzai, Yasuji
- Department of Hematology, Tokyo Metropolitan Tama Synthesis Medical Center
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- Murase, Tadashi
- Department of Laboratory Medicine, Dokkyo Medical University Koshigaya Hospital
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- Matsue, Kosei
- Division of Hematology/Oncology, Department of Internal Medicine, Kameda Medical Center
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- Morita, Satoshi
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine
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- Sakamoto, Junichi
- Tokai Central Hospital
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- Wakita, Hisashi
- Division of Hematology and Oncology, Japanese Red Cross Society, Narita Red Cross Hospital
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- Sakamaki, Hisashi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center
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- Inokuchi, Koiti
- Department of Hematology, Nippon Medical School
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抄録
Tyrosine kinase inhibitors (TKI) improve the prognosis of patients with chronic myelogenous leukemia (CML) by inducing substantial deep molecular responses (DMR); some patients have successfully discontinued TKI therapy after maintaining DMR for ≥1 year. In this cessation study, we investigated the optimal conditions for dasatinib discontinuation in patients who maintained DMR for ≥2 years. This study included 54 patients with CML who were enrolled in a D‐STOP multicenter prospective trial, had achieved DMR, and had discontinued dasatinib after 2‐year consolidation. Peripheral lymphocyte profiles were analyzed by flow cytometry. The estimated 12‐month treatment‐free survival (TFS) was 62.9% (95% confidence interval: 48.5%‐74.2%). During dasatinib consolidation, the percentage of total lymphocytes and numbers of CD3⁻ CD56⁺ natural killer (NK) cells, CD16⁺ CD56⁺ NK cells and CD56⁺ CD57⁺ NK‐large granular lymphocytes (LGL) were significantly higher in patients with molecular relapse after discontinuation but remained unchanged in patients without molecular relapse for >7 months. At the end of consolidation, patients whose total lymphocytes comprised <41% CD3⁻ CD56⁺ NK cells, <35% CD16⁺ CD56⁺ NK cells, or <27% CD56⁺ CD57⁺ NK‐LGL cells had higher TFS relative to other patients (77% vs 18%; P < .0008; 76% vs 10%; P < .0001; 84% vs 46%; P = .0059, respectively). The increase in the number of these NK cells occurred only during dasatinib consolidation. In patients with DMR, dasatinib discontinuation after 2‐year consolidation can lead to high TFS. This outcome depends significantly on a smaller increase in NK cells during dasatinib consolidation.
収録刊行物
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- Cancer Science
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Cancer Science 109 (1), 182-192, 2018-01
Wiley-Blackwell
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詳細情報 詳細情報について
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- CRID
- 1050564285810861824
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- NII論文ID
- 120006460074
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- ISSN
- 13479032
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- HANDLE
- 2433/230808
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- 本文言語コード
- en
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- 資料種別
- journal article
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- データソース種別
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- IRDB
- CiNii Articles