title: Long-term efficacy of imatinib in a practical setting is correlated with imatinib trough concentration that is influenced by body size: a report by the Nagasaki CML Study Group.
abstract: Imatinib has dramatically improved long-term survival of chronic myelogenous leukemia (CML) patients. To analyze its efficacy in a practical setting, we registered most of CML patients in Nagasaki Prefecture of Japan. Of these, 73 patients received imatinib as an initial therapy. The overall survival rate of these patients was 88.7% at 6 years, and the cumulative complete cytogenetic response rate was 82.5% at 18 months. These results are comparable with the data of other reports including the IRIS study; however, the administered imatinib dose was smaller in our study than that in other reports. To address these discrepancies, we measured the trough concentration of imatinib among 35 patients. Although 39% of the patients were administered less than 400 mg/day, the trough level was comparable to those of previous reports. The trough level of imatinib showed a significant relationship with its efficacy, and was clearly related to dose of imatinib administrated and dose of imatinib divided by body surface area (BSA). Considering the smaller BSA of Japanese patients as compared to those of foreign origin, the results suggest that a lower dose of imatinib could maintain enough trough level and provided excellent results for the treatment of CML in our registry.
authors.affiliation: Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Sakai
authors.affiliation: Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan. y-miyaza@nagasaki-u.ac.jp.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Miyazaki
authors.affiliation: Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Matsuo
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Yukiyoshi
authors.initials: Y
authors.lastname: Moriuchi
authors.affiliation: Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Hata
authors.affiliation: Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Fukushima
authors.affiliation: Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Imaizumi
authors.affiliation: Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Imanishi
authors.affiliation: Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Taguchi
authors.affiliation: Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Iwanaga
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Tsushima
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Yoriko
authors.initials: Y
authors.lastname: Inoue
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Takasaki
authors.affiliation: Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tsuchiya
authors.affiliation: Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: Minori
authors.initials: M
authors.lastname: Komoda
authors.affiliation: Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Ando
authors.affiliation: Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Horio
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Moriwaki
authors.affiliation: Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Tominaga
authors.affiliation: Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Itonaga
authors.affiliation: Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nagai
authors.affiliation: Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Tsukasaki
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Chizuko
authors.initials: C
authors.lastname: Tsutsumi
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Sawayama
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Reishi
authors.initials: R
authors.lastname: Yamasaki
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ogawa
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Kawaguchi
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ikeda
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Onimaru
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Tawara
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Sunao
authors.initials: S
authors.lastname: Atogami
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Koida
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Joh
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Masaomi
authors.initials: M
authors.lastname: Yamamura
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Matsuo
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Soda
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nonaka
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Itsuro
authors.initials: I
authors.lastname: Jinnai
authors.affiliation: Nagasaki CML Study Group, Nagasaki, Japan.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Kuriyama
authors.affiliation: Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Tomonaga
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D049628:Body Size / Q000187:drug effects*; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate; D007564:Japan; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D015996:Survival Rate; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate