No clinical evidence for performing trough plasma and intracellular imatinib concentrations monitoring in patients with chronic myelogenous leukaemia |
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| Authors: | Hana Klamova Jaroslava Voglova Petra Belohlavkova Ludmila Malaskova David Potesil Jan Muzik Daniela Zackova Katerina Machova Polakova Zbynek Zdrahal Jana Malakova Jiri Suttnar Jan Dyr Jiri Mayer |
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| Affiliation: | 1. Institute of Hematology and Blood Transfusion, Prague, Czech Republic;2. IV. Department of Internal Medicine — Hematology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic;3. Department of Clinical Biochemistry, University Hospital Brno, Brno, Czech Republic;4. CEITEC ‐ Central European Institute of Technology, Masaryk University, Brno, Czech Republic;5. Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic;6. Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Brno, Czech Republic;7. Faculty of Medicine, Masaryk University, Brno, Czech Republic;8. National Centre for Biomolecular Research, Faculty of Science, Masaryk University, Brno, Czech Republic;9. Institute of Clinical Biochemistry and Diagnostics, Charles University in Prague, Faculty of Medicine and University Hospital Hradec Kralove, Hradec Kralove, Czech Republic |
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| Abstract: | This multicentre study focused on monitoring imatinib mesylate (IMA) trough plasma (Ctrough) and intracellular (IMA Cintrac) concentrations in 228 chronic myelogenous leukaemia patients. The median of measured IMA Ctrough in our patient group was 905.8 ng ml (range: 27.7–4628.1 ng/ml). We found a correlation between IMA Ctrough and alpha 1‐acid glycoprotein plasma concentrations (rS = 0.42; p < 0.001). All other analysed parameters revealed only weak (gender, dose of IMA per kg) or not significant (age, albumin, creatinine plasma concentration or body mass index) impact on measured IMA Ctrough. The IMA Ctrough decreased during the first 6 months and significantly increased later during treatment. The IMA Ctrough at the first month of therapy did not differ between patients with and without an optimal response at the 12th (p = 0.724) and 18th month (p = 0.135) of therapy. There were no significant differences in medians of IMA Ctrough between both groups measured during the first year of treatment. The IMA Cintrac during the first month were not different between patients with and without an optimal response at the 6th (p = 0.273) and the 12th month (p = 0.193) of therapy. Our data obtained from real life clinical practice did not find a benefit of routine and regular IMA Ctrough nor IMA Cintrac therapeutic drug monitoring in chronic myelogenous leukaemia patients or for subsequent adjustments of the IMA dose based on these results. Moreover, actual alpha 1‐acid glycoprotein plasma concentration should be used for proper interpretation of IMA Ctrough results. Copyright © 2013 John Wiley & Sons, Ltd. |
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| Keywords: | CML imatinib plasma concentration cell‐associated concentration |
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