Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Akita, Japan.
Clin Pharmacol Ther. 2010 Dec;88(6):809-13. doi: 10.1038/clpt.2010.186. Epub 2010 Oct 27.
Despite the outstanding results generally obtained with imatinib mesylate (IM) in the treatment of chronic myeloid leukemia (CML), some patients show a poor molecular response. To evaluate the relationship between steady-state trough plasma IM concentration (IM-C(min)) and clinical response in CML patients, we integrated data from six independent Japanese studies. Among 254 CML patients, the mean IM-C(min) was 1,010.5 ng/ml. Importantly, IM-C(min) was significantly higher in patients who achieved a major molecular response (MMR) than in those who did not (P = 0.002). Multivariate analysis showed that an MMR was associated with both age (odds ratio (OR) = 0.97 (0.958-0.995); P = 0.0153) and with IM-C(min) (OR = 1.0008 (1.0003-1.0015); P = 0.0044). Given that patients with IM-C(min) values >1,002 ng/ml had a higher probability of achieving an MMR in our large cohort (P = 0.0120), the data suggest that monitoring of IM levels in plasma may improve the efficacy of IM therapy for CML patients.
尽管甲磺酸伊马替尼（IM）在治疗慢性髓性白血病（CML）方面取得了出色的总体结果，但一些患者的分子反应较差。为了评估 CML 患者稳态谷血浆 IM 浓度（IM-C(min)）与临床反应之间的关系，我们整合了来自六项独立的日本研究的数据。在 254 例 CML 患者中，IM-C(min)的平均值为 1010.5ng/ml。重要的是，达到主要分子反应（MMR）的患者的 IM-C(min)显著高于未达到 MMR 的患者（P=0.002）。多变量分析表明，MMR 与年龄（优势比（OR）=0.97（0.958-0.995）；P=0.0153）和 IM-C(min)（OR=1.0008（1.0003-1.0015）；P=0.0044）相关。鉴于我们的大样本中，IM-C(min)值>1002ng/ml 的患者更有可能达到 MMR（P=0.0120），这些数据表明监测血浆中的 IM 水平可能会提高 IM 治疗 CML 患者的疗效。
