Altered Bone and Mineral Metabolism in Patients Receiving Imatinib Mesylate

[Guest guest]

Hello CML buddies!

Has anybody written to or spoken to a CML expert regarding this

latest study, and/or if they are going to broaden this study?

Should we all be getting periodic " Serum Phosphate " monitoring with

this news...and also possibly Bone Density screenings... or at least

a baseline? Maybe they will discuss at the next ASH possibly...?

This is very important news. I wanted to ask Dr. Nimer about it

during the CML teleconference today, but was not able to get through

the telephone lines..

Did anybody listen to it? I thought that it was an excellent RECAP

about CML basics and spoken in an easy,layman fashion-very through.

My only wish would be that they gave it more time. An hour is not

enough time to cover such a broad scope. Plus, they always ask

people to keep their quesitions " broad " in nature, and it always

turns out to be a personal consult..

Sincerely, Lynn (Snickersunny)

DX'd 12/03

PCRU

400 mg Gleevec.

>

> Altered Bone and Mineral Metabolism in Patients Receiving Imatinib

Mesylate

>

> Ellin Berman, M.D., Nicolaides, M.D., G. Maki, M.D.,

Ph.D.,

> Fleisher, Ph.D., Suzanne Chanel, R.N., Scheu, R.N.,

Bri-Anne

> , B.A., Glenn Heller, Ph.D., and P. Sauter, M.D.

>

>

> ABSTRACT

>

> Background Imatinib mesylate inhibits several tyrosine kinases,

including

> BCR-ABL, the C-KIT receptor, and the platelet-derived growth factor

> receptors {alpha} <http://content.nejm.org/math/alpha.gif> and

beta

> <http://content.nejm.org/math/beta.gif> , all of which are

associated with

> disease. We observed that hypophosphatemia developed in some

patients with

> either chronic myelogenous leukemia or gastrointestinal stromal

tumors who

> were receiving imatinib.

>

>

> Methods We identified 16 patients who had low serum phosphate

levels and 8

> patients who had normal serum phosphate levels, all of whom were

receiving

> imatinib. We performed the following biochemical measurements:

whole-blood

> levels of ionized calcium, plasma levels of intact parathyroid

hormone, and

> serum levels of total calcium, phosphate, 25-hydroxyvitamin D,

> 1,25-dihydroxyvitamin D, magnesium, and markers of bone formation

(bone

> alkaline phosphatase and osteocalcin) and bone resorption (N-

telopeptide of

> collagen cross-links); urinalysis; and phosphate, calcium, and

creatinine

> levels in " spot " urine specimens.

>

>

> Results Patients in the low-phosphate group (median serum phosphate

level,

> 2.0 mg per deciliter [0.6 mmol per liter]; normal level, >2.5 mg per

> deciliter [0.8 mmol per liter]) had elevated parathyroid hormone

levels and

> low-to-normal serum calcium levels, were younger, and were

receiving a

> higher dose of imatinib than patients in the normal-phosphate group

(median

> level, 3.2 mg per deciliter [1.0 mmol per liter]). Both groups had

high

> levels of phosphate excreted in the urine and markedly decreased

serum

> levels of osteocalcin and N-telopeptide of collagen cross-links.

>

>

> Conclusions Hypophosphatemia, with associated changes in bone and

mineral

> metabolism, develops in a proportion of patients taking imatinib

for either

> chronic myelogenous leukemia or gastrointestinal stromal tumors.

The drug

> may inhibit bone remodeling (formation and resorption), even in

patients

> with normal serum phosphate levels.

>

>

>

>

> Source Information

>

>

> From the Departments of Medicine (E.B., M.N., R.G.M., S.C., K.S.,

B.-A.W.,

> N.P.S.), Clinical Laboratories (M.F.), and Epidemiology and

Biostatistics

> (G.H.), Memorial Sloan-Kettering

>

>

>

> Stratégie de Communication Med Summit Inc/Sommets Médical

>

> FMC/FSC Stratégie de Communication, Planification et Coordination

>

> CME/CHE Communication Strategy, Planning and Coordination Tel: (1)

> 514-782-2004 Fax (1) 514-782-8777

>

> This e-mail and any attachments may contain confidential

information. If you

> are not the intended recipient, please notify the sender

immediately by

> return e-mail, delete this e-mail and destroy any copies. Any

dissemination

> or use of this information by a person other than the intended

recipient is

> unauthorized and may be illegal.Med Summit Inc. reserves the right

to

> monitor all e-mail communications through its networks for quality

control

> purposes. Ce message électronique et les fichiers qui y sont

joints peuvent

> contenir des renseignements confidentiels. Si vous n'êtes pas le

> destinataire visé, veuillez en aviser immédiatement l'expéditeur en

> répondant à ce message; effacez ensuite le message et détruisez

toute copie.

> La diffusion ou l'usage de ces renseignements par une personne

autre que le

> destinataire visé n'est pas autorisé et peut constituer un acte

illégal. Med

> Summit/Sommets Médical Inc. se réserve le droit de surveiller

toutes les

> communications transmises par courrier électronique par

l'intermédiaire de

> ses réseaux à des fins de contrôle de la qualité.

>

>

>

>

>