Imatinib plasma concentration – a new laboratory parameter for monitoring the treatment of Slovenian patients with chronic myeloid leukemia
2011
Background: In past ten years imatinib (IM)
has greatly improved the prognosis of patients
with chronic myeloid leukemia (CML). However,
30 % of patients still fail to achieve treatment
goals or cannot maintain them later. In the
last three years, Imatinib plasma concentration
(IPC) has been mentioned as a possible influence
on treatment success. Therefore, for the first time
in Slovenia, we searched for possible connection
between IPC and treatment success defined
as a major molecular response (MMR) until 18
months of treatement.
Patients and methods: We included 75 patients
with CML who had been receiving IM at that
time of the study and were diagnosed in a chronic
or accelerated phase of CML. Blood samples
for IPC determination were sent to a reference
laboratory in Bordeaux. We set up a method of
IPC determination in Slovenia.
Results: Association between IPC and MMR
achievement until 18 months of tretment was not
statistically significant in patients receiving 400 mg of imatinib (p = 0.30). Age and time from
the second to last dose of IM were not associated
with IPC (p = 0.47 and 0.80, respectively), while
gender and dose were (p for both < 0.01).
Conclusions: There was no clear correlation
between IPC and MMR achievement until 18 months of treatment. We conclude that IPC determination
would be rational in patents who fail
to meet the generally accepted criteria for treatment
success, in patients who experience severe
side effects of IM, or patients receiving drugs that
cause a pharmacokinetic interference with IM.
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