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No clinical evidence for performing trough plasma and intracellular imatinib concentrations monitoring in patients with chronic myelogenous leukaemia
Author(s) -
Racil Zdenek,
Razga Filip,
Klamova Hana,
Voglova Jaroslava,
Belohlavkova Petra,
Malaskova Ludmila,
Potesil David,
Muzik Jan,
Zackova Daniela,
Polakova Katerina Machova,
Zdrahal Zbynek,
Malakova Jana,
Suttnar Jiri,
Dyr Jan,
Mayer Jiri
Publication year - 2014
Publication title -
hematological oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 44
eISSN - 1099-1069
pISSN - 0278-0232
DOI - 10.1002/hon.2091
Subject(s) - trough (economics) , medicine , trough level , trough concentration , therapeutic drug monitoring , chronic myelogenous leukemia , therapeutic index , imatinib , plasma concentration , gastroenterology , creatinine , surgery , urology , pharmacology , pharmacokinetics , drug , leukemia , myeloid leukemia , transplantation , economics , macroeconomics , tacrolimus
This multicentre study focused on monitoring imatinib mesylate (IMA) trough plasma (C trough ) and intracellular (IMA C intrac ) concentrations in 228 chronic myelogenous leukaemia patients. The median of measured IMA C trough in our patient group was 905.8 ng ml (range: 27.7–4628.1 ng/ml). We found a correlation between IMA C trough 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 C trough. The IMA C trough decreased during the first 6 months and significantly increased later during treatment. The IMA C trough 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 C trough between both groups measured during the first year of treatment. The IMA C intrac 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 C trough nor IMA C intrac 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 C trough results. Copyright © 2013 John Wiley & Sons, Ltd.