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Clinical and prognostic significance of histamine monitoring in patients with CML during treatment with imatinib (STI571).

AbstractBACKGROUND: Although imatinib is highly effective in chronic myeloid leukemia (CML), drug-resistance may occur. Therefore, monitoring of minimal residual disease (MRD) during treatment with imatinib is important. However, most MRD-parameters are expensive and require special technology. We determined the value of histamine as MRD-marker in CML. PATIENTS AND METHODS: Histamine levels were measured serially in whole blood samples before and during imatinib therapy in 80 CML patients by radioimmunoassay. RESULTS: Histamine levels were highly upregulated in CML at diagnosis compared to healthy controls, and correlated with the presence of basophils. During treatment with imatinib, histamine levels decreased and returned to normal levels in those achieving a complete cytogenetic response (CCR). Loss of CCR during therapy was invariably accompanied by an increase in histamine. Moreover, a histamine level of >100 ng/ml three or six months after start of imatinib was associated with a significantly reduced probability of survival (p<0.05). Whereas basophils were found to correlate well with histamine during imatinib, no correlations were found between histamine and Ph+ metaphases or histamine and BCR/ABL. CONCLUSION: Histamine-monitoring during treatment with imatinib is of prognostic significance.
AuthorsH Agis, W R Sperr, S Herndlhofer, H Semper, H Pirc-Danoewinata, O A Haas, C Mannhalter, H Esterbauer, K Geissler, C Sillaber, U Jäger, P Valent (Affiliation: Department of Internal Medicine I, Division of Hematology and Hemostaseology, Center of Excellence for Clinical and Experimental Oncology (CLEXO), Medical University of Vienna, Austria.)
JournalAnnals of oncology : official journal of the European Society for Medical Oncology / ESMO (Ann Oncol) Vol. 18 Issue 11 Pg. 1834-41 (Nov 2007) ISSN: 1569-8041 England
PMID17804468 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Biological Markers
  • Piperazines
  • Pyrimidines
  • imatinib
  • Histamine
Topics
  • Administration, Oral
  • Adult
  • Aged
  • Aged, 80 and over
  • Biological Markers (blood)
  • Cohort Studies
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Histamine (blood, metabolism)
  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive (blood, drug therapy, mortality)
  • Male
  • Middle Aged
  • Monitoring, Physiologic (methods)
  • Neoplasm, Residual (blood, diagnosis)
  • Piperazines (administration & dosage)
  • Probability
  • Prognosis
  • Pyrimidines (administration & dosage)
  • Radioimmunoassay
  • Risk Assessment
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Survival Analysis
  • Treatment Outcome