Reduced Dose of Imatinib for Patients with Chronic Myeloid Leukemia and Low Body Surface Area

Park, Seh Jong; Choi, In Keun; Seo, Hyungjoon; Sung, Hwa Jung; Park, Kyong Hwa; Kim, Seok Jin; Oh, Sang Cheul; Seo, Jae Hong; Choi, Chul Won; Kim, Byung Soo; Shin, Sang Won; Kim, Yeul Hong; Kim, Jun Suk

doi:10.1159/000111777

Cited by 23 publications

(23 citation statements)

References 6 publications

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“…Although not observed to any great degree in other studies, there are suggestions of differential ethnic tolerance and efficacy of TKIs. 20,21 Despite its obvious limitations, including retrospective study design and selective populations, this study confirmed that survival of patients harboring a T315I mutation remains dependent on the disease phase at T315I mutation detection, as well as the disease history during patients' lifetime. The fact that we did not observe clear treatment pattern after T315I mutation detection highlights the need for early detection of this mutation in clinically TKI-resistant patients to optimally manage this selective and still elusive resistance pattern with current and emerging therapeutics.…”

Section: Discussionsupporting

confidence: 60%

Epidemiologic study on survival of chronic myeloid leukemia and Ph+ acute lymphoblastic leukemia patients with BCR-ABL T315I mutation

Nicolini

Mauro

Martinelli

et al. 2009

Blood

117

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The BCR-ABL T315I mutation represents a major mechanism of resistance to tyrosine kinase inhibitors (TKIs). The objectives of this retrospective observational study were to estimate overall and progression-free survival for chronic myeloid leukemia in chronic-phase (CP), accelerated-phase (AP), or blasticphase (BP) and Philadelphia chromosome-positive (Ph) ؉ acute lymphoblastic leukemia (ALL) patients with T315I mutation. Medical records of 222 patients from 9 countries were reviewed; data were analyzed using log-rank tests and Cox proportional hazard models. Median age at T315I mutation detection was 54 years; 57% cases were men. Median time between TKI treatment initiation and T315I mutation detection was 29.2, 15.4, 5.8, and 9.1 months, respectively, for CP, AP, BP, and Ph ؉ ALL patients. After T315I mutation detection, second-generation TKIs were used in 56% of cases, hydroxyurea in 39%, imatinib in 35%, cytarabine in 26%, MK-0457 in 11%, stem cell transplantation in 17%, and interferon-␣ in 6% of cases. Median overall survival from T315I mutation detection was 22.4, 28.4, 4.0, and 4.9 months, and median progression-free survival was 11.5, 22.2, 1.8, and 2.5 months, respectively, for CP, AP, BP, and Ph ؉ ALL patients. These results confirm that survival of patients harboring a T315I mutation is dependent on disease phase at the time of mutation detection.

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Section: Discussionsupporting

confidence: 60%

Epidemiologic study on survival of chronic myeloid leukemia and Ph+ acute lymphoblastic leukemia patients with BCR-ABL T315I mutation

Nicolini

Mauro

Martinelli

et al. 2009

Blood

117

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“…In Japanese studies, grade 3 or 4 neutropenia and/or leukocytopenia occurred in 33.3% of patients, and grade 3 thrombocytopenia occurred in 12.8% of patients [29] . Given Asians' lower body weight and BSA, both Korean and Japanese doctors doubted whether 400 mg daily of imatinib was an optimal initial dose for Asian patients and proposed a lower dose [30][31][32][33][34] . We found that the imatinib plasma trough concentration of Chinese patients who received 400 mg imatinib daily was higher than that of Caucasian patients, which provides convincing proof that Asian patients with lower body weight or BSA need a lower dose of imatinib than Caucasian CML patients.…”

Section: Discussionmentioning

confidence: 99%

Imatinib plasma trough concentration and its correlation with characteristics and response in Chinese CML patients

Chen

et al. 2010

Acta Pharmacol Sin

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Aim: To investigate the pharmacokinetics of imatinib in Chinese chronic myelogenous leukemia (CML) patients. Methods: Fourty-six naïve Chinese CML patients treated with imatinib (400 and 600 mg daily, n=36 and 10, respectively) were recruited. The correlations of imatinib (400 mg) trough plasma concentrations (C mins ) with the patients' characteristics and responses were analyzed. Results: The overall mean (±SD, CV%) steady-state C mins for imatinib at 400 mg (n=36) and 600 mg (n=10) daily was 1325.61 ng/mL (±583.53 ng/mL; 44%) and 1550.90 ng/mL (±462.63 ng/mL; 30%), respectively, and no statistically significant differences were found between them (P=0.267). At 400 mg daily, female patients had significantly higher C mins than the male patients (P=0.048), and molecular responses were not correlated with imatinib C mins , but they were correlated with time elapsed before imatinib therapy. Conclusion:The results suggest that Chinese CML patients have higher imatinib C mins than their Caucasian counterparts and that the optimal initial imatinib dose for them requires further investigation.

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“…It is usually difficult and also very important in clinical terms to choose a suitable therapeutic method because there is very strong heterogeneity among patients with IM intolerance [1]. Many researchers report that serious treatment-related AEs, which often lead to the interruption of treatment or a decreased dose of IM, are often associated with an unfavorable outcome [2,3], but others report that some AEs, after a decreased dose of IM, have no distinct influence on patient outcome [4,5]. Some studies also show that even with grade 3 or more, some patients may still continue or return to IM therapy without their outcome being adversely affected [6].…”

Section: Tablementioning

confidence: 99%

Continuing Imatinib Treatment for Chronic Myeloid Leukemia Patients Who Had Serious Adverse Events at the Onset of Therapy

din²,

Yu³

et al. 2017

Acta Haematol

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Reduced Dose of Imatinib for Patients with Chronic Myeloid Leukemia and Low Body Surface Area

Cited by 23 publications

References 6 publications

Epidemiologic study on survival of chronic myeloid leukemia and Ph+ acute lymphoblastic leukemia patients with BCR-ABL T315I mutation

Epidemiologic study on survival of chronic myeloid leukemia and Ph+ acute lymphoblastic leukemia patients with BCR-ABL T315I mutation

Imatinib plasma trough concentration and its correlation with characteristics and response in Chinese CML patients

Continuing Imatinib Treatment for Chronic Myeloid Leukemia Patients Who Had Serious Adverse Events at the Onset of Therapy

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