Trough plasma imatinib levels are correlated with optimal cytogenetic responses at 6 months after treatment with standard dose of imatinib in newly diagnosed chronic myeloid leukemia
Trough plasma imatinib levels are correlated with optimal cytogenetic responses at 6 months after treatment with standard dose of imatinib in newly diagnosed chronic myeloid leukemia
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DOI：
10.3109/10428194.2011.563885
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发表时间：
2011-06-01
影响因子：
2.6
通讯作者：
Park, Seon Yang
中科院分区：
文献类型：
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作者：
Sohn, Sang Kyun;Oh, Suk Joong;Park, Seon Yang
为了研究甲磺酸伊马替尼 (IM) 谷值水平与细胞遗传学或分子反应的相关性，我们测量了慢性粒细胞白血病慢性期 (CML-CP) 患者在接受标准剂量 IM 治疗 6 个月时的 IM 谷值水平。前瞻性招募了 87 名新诊断的 CML-CP 患者。 78 名患者 (89.7%) 在 6 个月时表现出最佳反应（完全或部分细胞遗传学反应）。 IM 谷值水平为 1378 +/- 725 ng/mL。当分为两组时，6个月时具有最佳和次优缓解的患者数量（< 1000组：80.6% vs. 19.4%；>= 1000：94.6% vs. 5.4%；p=0.032）以及6个月时出现早期主要分子缓解（early-MMR）和无MMR的患者数量（< 1000：3.2% 与 96.8%；>= 1000：21.4% 与 78.6%；p=0.047）。总之，与谷值水平 < 1000 的患者相比，接受 IM 治疗 6 个月的 CML-CP 患者中，最佳细胞遗传学反应或早期 MMR 的发生率显着高于那些谷值水平 < 1000 的患者。对于对标准 IM 剂量表现出次优反应或耐药的 CML 患者，尤其是血浆 IM 谷值水平较低 (< 1000 ng/mL) 的 CML 患者，IM 剂量递增可能是一种选择。
To investigate the correlation of trough imatinib mesylate (IM) levels with cytogenetic or molecular responses, we measured trough IM levels in patients with chronic myeloid leukemia, chronic phase (CML-CP), at 6 months of treatment with a standard dose of IM. Eighty-seven newly diagnosed patients with CML-CP were prospectively enrolled. Seventy-eight patients (89.7%) showed an optimal response (complete or partial cytogenetic response) at 6 months. Trough IM levels were 1378 +/- 725 ng/mL. When categorized into two groups, there was a statistically significant difference in numbers of patients with optimal and suboptimal responses at 6 months (group with < 1000: 80.6% vs. 19.4%; >= 1000: 94.6% vs. 5.4%; p=0.032), and in numbers of patients with early major molecular response (early-MMR) and without MMR at 6 months (group with < 1000: 3.2% vs. 96.8%; >= 1000: 21.4% vs. 78.6%; p=0.047). In conclusion, the incidence of optimal cytogenetic response or early-MMR in patients with CML-CP treated with IM for 6 months was significantly higher in those with a trough level of >= 1000 compared with those with a level of < 1000. Dose escalation of IM can be one option in patients with CML showing suboptimal response or resistance to the standard dose of IM, especially with low trough plasma IM levels (< 1000 ng/mL).