伊马替尼血药浓度的临床相关性研究

Research on the clinical correlation of imatinib plasama concentration

目的探讨伊马替尼(IM)血药浓度监测在指导慢性粒细胞白血病(CML)治疗中的意义。方法利用液相色谱-质谱联用(LC-MS/MS)法对153例正规服用IM治疗CML患者进行IM血浆浓度监测,分析血药浓度与患者一般特征及疗效的关系。结果①IM血药浓度水平与患者性别、年龄、身高、体重、体表面积以及服用IM时间无相关性;②111例标准剂量IM治疗CML患者中有86例获得完全细胞遗传学缓解(CCyR),在Q1、Q2～Q3和Q4组分别为18例(67.7%,18/27)、50例(87.7%,50/57)和18例(67.7%,18/27),3组间差异有统计学意义(P<0.05);86例获得CCyR的患者血浆谷浓度水平高于25例未获得CCyR的患者,差异有统计学意义(P<0.05);106例进行分子生物学评估的患者中,63例获得分子生物学缓解(MMR),IM血浆谷浓度水平高于未获得MMR的43例患者,差异有统计学意义(P<0.05)。结论 IM血药浓度水平与患者性别、年龄、身高、体重、体表面积等一般特征无关,与临床疗效有一定关系。

To detect the imatinib（IM） plasma concentration of chronic myeloid leukemiac （CML） patients and explore its clinical significance. Methods IM plasma concentration of the 153 CML patients taking regular treatment of IM were detected with liquid chromatography-mass-spectrometry（ LC-MS/MS）, and the correlation of IM plasma concentration with general characteristics of patients were analyzed. Results①IM plasma concentration levels was no correlation with gender, age, height, body weight, body surface area and taking IM time. ② 111 cases of standard-dose IM in treatment of CML patients, 86 cases achieved complete cytogenetic response （CCyR）, group Q1, Q2 -Q3, and Q4 had 18（67.7%, 18/27）, 50（87.7%, 50/57） and 18 cases （67.7%, 18/27） respectively. There was significantly different among them（P 〈0.05 ）. 86 cases received CCyR plasma trough level concentrations in patients were higher than that of 25 cases without the CCyR （P 〈 0. 05 ）, and in the 106 cases of that received MMR,63 cases with the level were higher than 43 cases of patients without the MMR valley plasma concentrations（P 〈 0.05 ）. Conclusion IM plasma concentration levels has no correlation with patient sex, age, height, weight, body surface area, but effect the clinical efficacy.