1. A clinically relevant pharmacokinetic interaction between cyclosporine and imatinib
- Author
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Birgit C. P. Koch, Teun van Gelder, Ferdows Atiq, Jorie Versmissen, Annoek E.C. Broers, Jeanette K. Doorduijn, Louise M. Andrews, Hematology, Pharmacy, and Internal Medicine
- Subjects
Adult ,Male ,Oncology ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Antineoplastic Agents ,Hematopoietic stem cell transplantation ,Pharmacology ,Graft-versus-host disease ,030226 pharmacology & pharmacy ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Leukemia, Myelogenous, Chronic, BCR-ABL Positive ,hemic and lymphatic diseases ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Drug Interactions ,Pharmacology (medical) ,In patient ,Protein Kinase Inhibitors ,Aged ,CYP3A4 ,business.industry ,Hematopoietic Stem Cell Transplantation ,Myeloid leukemia ,Imatinib ,General Medicine ,Middle Aged ,Pharmacokinetics and Disposition ,medicine.disease ,030220 oncology & carcinogenesis ,Concomitant ,Cyclosporine ,Imatinib Mesylate ,Female ,business ,Immunosuppressive Agents ,Pharmacokinetic interaction ,medicine.drug - Abstract
Purpose Cyclosporine A (CsA) and imatinib are both CYP3A4 and P-glycoprotein substrates. Concomitant use after hematopoietic stem cell transplantation (HSCT) for chronic myeloid leukemia (CML) or Philadelphia chromosome-positive (Ph+) acute lymphatic leukemia (ALL) may therefore result in a pharmacokinetic interaction. Although case reports and a recent small study in children indeed suggested there is a relevant pharmacokinetic interaction, a larger study in adults is lacking. In this study, we assessed the presence and extent of this interaction in patients with CML or Ph+ ALL undergoing HSCT. Methods From a large database containing data of all patients receiving HSCT in our center between 2005 and 2015, we selected 16 patients using this drug combination. The average dose-corrected CsA concentration was calculated before and after initiation of imatinib. Results The average dose-corrected CsA concentration increased during imatinib use in all patients, on average by 94 % (p
- Published
- 2016
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