Chronic myeloid leukaemia (CML) Philadelphia chromosome (bcr-abl) positive (Ph+)

Active Ingredient: Imatinib

Indication for Imatinib

Population group: only children (1 year - 12 years old) , adolescents (12 years - 18 years old)

Imatinib is indicated for the treatment of:

  • adult and paediatric patients with newly diagnosed Philadelphia chromosome (bcr-abl) positive (Ph+) chronic myeloid leukaemia (CML) for whom bone marrow transplantation is not considered as the first line of treatment.
  • adult and paediatric patients with Ph+ CML in chronic phase after failure of interferon-alpha therapy, or in accelerated phase or blast crisis.

For this indication, competent medicine agencies globally authorize below treatments:

340-570 mg/m² in 1-2 divided doses daily

Dosage regimens

Oral, between 170 milligrams imatinib per square meter of body surface and 285 milligrams imatinib per square meter of body surface, 2 times daily.

Detailed description

Dosing for children should be on the basis of body surface area (mg/m²). The dose of 340 mg/m² daily is recommended for children with chronic phase CML and advanced phase CML (not to exceed the total dose of 800 mg). Treatment can be given as a once daily dose or alternatively the daily dose may be split into two administrations – one in the morning and one in the evening. The dose recommendation is currently based on a small number of paediatric patients. There is no experience with the treatment of children below 2 years of age.

Dose increases from 340 mg/m² daily to 570 mg/m² daily (not to exceed the total dose of 800 mg) may be considered in children in the absence of severe adverse drug reaction and severe non-leukaemia-related neutropenia or thrombocytopenia in the following circumstances: disease progression (at any time); failure to achieve a satisfactory haematological response after at least 3 months of treatment; failure to achieve a cytogenetic response after 12 months of treatment; or loss of a previously achieved haematological and/or cytogenetic response. Patients should be monitored closely following dose escalation given the potential for an increased incidence of adverse reactions at higher dosages.

Dosage considerations

The prescribed dose should be administered orally with a meal and a large glass of water to minimise the risk of gastrointestinal irritations.

Active ingredient

Imatinib

Imatinib is a protein-tyrosine kinase inhibitor which potently inhibits the Bcr-Abl tyrosine kinase at the in vitro, cellular and in vivo levels.

Read more about Imatinib

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