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.
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.
Sakai
Mari
M
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.
Miyazaki
Yasushi
Y
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.
Matsuo
Emi
E
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.
Moriuchi
Yukiyoshi
Y
Nagasaki CML Study Group, Nagasaki, Japan.
Hata
Tomoko
T
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.
Fukushima
Takuya
T
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.
Imaizumi
Yoshitaka
Y
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.
Imanishi
Daisuke
D
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.
Taguchi
Jun
J
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.
Iwanaga
Masako
M
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.
Tsushima
Hideki
H
Nagasaki CML Study Group, Nagasaki, Japan.
Inoue
Yoriko
Y
Nagasaki CML Study Group, Nagasaki, Japan.
Takasaki
Yumi
Y
Nagasaki CML Study Group, Nagasaki, Japan.
Tsuchiya
Takeshi
T
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.
Komoda
Minori
M
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.
Ando
Koji
K
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.
Horio
Kensuke
K
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.
Moriwaki
Yuji
Y
Nagasaki CML Study Group, Nagasaki, Japan.
Tominaga
Shinya
S
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.
Itonaga
Hidehiro
H
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.
Nagai
Kazuhiro
K
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.
Tsukasaki
Kunihiro
K
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.
Tsutsumi
Chizuko
C
Nagasaki CML Study Group, Nagasaki, Japan.
Sawayama
Yasushi
Y
Nagasaki CML Study Group, Nagasaki, Japan.
Yamasaki
Reishi
R
Nagasaki CML Study Group, Nagasaki, Japan.
Ogawa
Daisuke
D
Nagasaki CML Study Group, Nagasaki, Japan.
Kawaguchi
Yasuhisa
Y
Nagasaki CML Study Group, Nagasaki, Japan.
Ikeda
Shuichi
S
Nagasaki CML Study Group, Nagasaki, Japan.
Yoshida
Shinichiro
S
Nagasaki CML Study Group, Nagasaki, Japan.
Onimaru
Yasuyuki
Y
Nagasaki CML Study Group, Nagasaki, Japan.
Tawara
Masayuki
M
Nagasaki CML Study Group, Nagasaki, Japan.
Atogami
Sunao
S
Nagasaki CML Study Group, Nagasaki, Japan.
Koida
Satoshi
S
Nagasaki CML Study Group, Nagasaki, Japan.
Joh
Tatsuro
T
Nagasaki CML Study Group, Nagasaki, Japan.
Yamamura
Masaomi
M
Nagasaki CML Study Group, Nagasaki, Japan.
Matsuo
Yuji
Y
Nagasaki CML Study Group, Nagasaki, Japan.
Soda
Hisashi
H
Nagasaki CML Study Group, Nagasaki, Japan.
Nonaka
Hiroaki
H
Nagasaki CML Study Group, Nagasaki, Japan.
Jinnai
Itsuro
I
Nagasaki CML Study Group, Nagasaki, Japan.
Kuriyama
Kazutaka
K
Nagasaki CML Study Group, Nagasaki, Japan.
Tomonaga
Masao
M
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.
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
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate