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Journal of Pharmacology and PharmacotherapeuticsNOW IN
Article

Therapeutic Drug Monitoring of Imatinib in Patients of Chronic Myeloid Leukemia – Chronic Phase

Harshit Khurana1, Ashwini Kumar2, Abha Khurana3, Kumar Abhisheka4, Vijoy Kumar Jha5★★ Corresponding author

  1. 1Department of Clinical hematology, Medical Division, Command Hospital Air Force, Bengaluru, Karnataka, India.
  2. 2Department of Biochemistry, Armed Forces Medical College, Pune, Maharashtra, India.
  3. 3Department of Obstetrics and Gynaecology, Command Hospital Air Force, Bengaluru, Karnataka, India.
  4. 4Department of Endocrinology, Medical Divison Command hospital Air Force Bengaluru, Karnataka, India.
  5. 5Department of Nephrology, Medical Divison Command hospital Air Force Bengaluru, Karnataka, India.

CORRESPONDENCE

Vijoy Kumar Jha

Command Hospital Air Force, Bengaluru - 560 007, Karnataka, India.

vkjhadmnephro@gmail.com

Received: 06-03-2021; Revised: 02-06-2021; Accepted: 20-06-2021.

Volume 12, Issue 2 · pp. 61–67 · PUBLISHED 17 September 2021 · DOI: 10.4103/jpp.jpp_28_21

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ABSTRACT

Introduction: Tyrosine kinase inhibitor is recommended for the initial management of chronic phase chronic myeloid leukemia (CP CML) based on the more favorable balance of toxicity and long‑term disease control. Background: Mean trough plasma Imatinib Mesylate (IM) levels are detected to be significantly higher in patients with a complete cytogenetic response or major molecular response (MMR). Methodology: The primary objective of the study was to correlate the IM drug levels with MMR on two different occasions at least 3 months apart and to study the variation in the plasma trough levels of IM during the treatment with standard dose for at least 12 months. Results: After exclusion, 30 patients of CML‑CP in MMR, on standard dose over a period of 2 years were finally analyzed. The mean IM plasma levels (IPLs) of the first sample for all patients were 1722 ± 566 ng/ml (IPL‑1) with a corresponding mean molecular response (MR) 0.0257 ± 0.0279 breakpoint cluster region‑abelson murine leukemia (BCR‑ABL) IS % (MR‑1). The mean IPLs of the second sample for all patients were 1549 ± 375 ng/ml (IPL‑2) with a corresponding mean MR 0.0143 ± 0.0184 BCR‑ABL IS % (MR‑2). Area under the receiver operating characteristic curve for IPL‑1 was 0.565 and IPL‑2 was 0.639. For IM level at second point of 1800 ng/ml, the specificity for predicting MMR was 81.8% and sensitivity was 31.6%. Conclusion: Monitoring of trough IM plasma concentrations may become the part of standard management of CML patients.

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    Khurana, H., Kumar, A., Khurana, A., Abhisheka, K., & Jha, V. K. (2021). Therapeutic Drug Monitoring of Imatinib in Patients of Chronic Myeloid Leukemia – Chronic Phase. Journal of Pharmacology and Pharmacotherapeutics, 12(2), 61–67. https://doi.org/10.4103/jpp.jpp_28_21