Gleevec Versus Bloodletting

ironjustice

2012-01-06 12:55:01 UTC

On Jan 5, 7:39 pm, ironjustice <***@cool.zzn.com> wrote: In
theory it should work for diabetes. <<

Effect of the tyrosine kinase inhibitors (sunitinib, sorafenib,
dasatinib, and imatinib) on blood glucose levels in diabetic and
nondiabetic patients in general clinical practice.
Agostino NM, Chinchilli VM, Lynch CJ, Koszyk-Szewczyk A, Gingrich R,
Sivik J, Drabick JJ
J Oncol Pharm Pract 2011 Sep; 17(3):197-202.

Tyrosine kinase is a key enzyme activity utilized in many
intracellular messaging pathways.
Understanding the role of particular tyrosine kinases in malignancies
has allowed for the design of tyrosine kinase inhibitors (TKIs), which
can target these enzymes and interfere with downstream signaling.
TKIs have proven to be successful in the treatment of chronic myeloid
leukemia, renal cell carcinoma and gastrointestinal stromal tumor, and
other malignancies.
Scattered reports have suggested that these agents appear to affect
blood glucose (BG).
We retrospectively studied the BG concentrations in diabetic (17) and
nondiabetic (61) patients treated with dasatinib (8), imatinib (39),
sorafenib (23), and sunitinib (30) in our clinical practice.
Mean declines of BG were dasatinib (53 mg/dL), imatinib (9 mg/dL),
sorafenib (12 mg/dL), and sunitinib (14 mg/dL). All these declines in
BG were statistically significant.
Of note, 47% (8/17) of the patients with diabetes were able to
discontinue their medications, including insulin in some patients.
Only one diabetic patient developed symptomatic hypoglycemia while on
sunitinib.
The mechanism for the hypoglycemic effect of these drugs is unclear,
but of the four agents tested, c-kit and PDGFRβ are the common target
kinases.
Clinicians should keep the potential hypoglycemic effects of these
agents in mind; modification of hypoglycemic agents may be required in
diabetic patients.
These results also suggest that inhibition of a tyrosine kinase, be it
c-kit, PDGFRβ or some other undefined target, may improve diabetes
mellitus BG control and it deserves further study as a potential novel
therapeutic option.

Journal of oncology pharmacy practice : official publication of the
International Society of Oncology Pharmacy Practitioners [J Oncol
Pharm Pract]> Treatment of polycythemia vera with imatinib mesylate.

Who loves ya.
Tom

Jesus Was A Vegetarian!
http://tinyurl.com/2r2nkh

Man Is A Herbivore!
http://tinyurl.com/4rq595

DEAD PEOPLE WALKING
http://tinyurl.com/zk9fk

Post by ironjustice
Leuk Res. 2012 Feb;36(2):156-62. Epub 2011 Oct 7.
Silver RT, Bourla MH, Vandris K, Fruchtman S, Spivak JL, Feldman EJ,
Salvado AJ.
Division of Hematology and Medical Oncology, Department of Medicine,
Weill Cornell Medical College, New York, NY, USA.
Abstract
We treated 37 patients with polycythemia vera with imatinib mesylate
(IM).
The overall response rate was 49%.
Thirty percent had a complete response, and 19%, a partial response.
Thirty-one patients were treated for >120days.
Frequent side effects included nausea, diarrhea, edema, and skin
rash.
Whereas IM was effective in controlling erythropoiesis and reducing
spleen
size it was ineffective in controlling thrombocytosis.
Normocellular marrow developed in 4 patients who had a complete
response.
Progression to overt myelofibrosis occurred in 3.
Nevertheless, 6 patients have had a sustained complete response while
on
IM for >6years.
These patients were young, had high phlebotomy requirements, and only
slightly elevated platelet counts.
Therefore, we believe there may be a role for IM in patients with
these
characteristics whose disease cannot be controlled by, or as an
alternative
to, other myelosuppressive treatments.
Copyright © 2011 Elsevier Ltd. All rights reserved.
PMID:21983176
------------
Polycythemia Vera
Most newly diagnosed patients should undergo phlebotomy to obtain
symptomatic control of polycythemia.
-----------------
The cost of Gleevec for CML is $32,000 to $98,000
-----------------
In theory it should work for diabetes.
"Increased red blood cell count "
New aspects of the insulin resistance syndrome: impact on
haematological parameters.
Diabetologia. 2001 Oct;44(10):1232-7.
Barbieri M, Ragno E, Benvenuti E, Zito GA, Corsi A, Ferrucci L,
Paolisso G.
Department of Geriatric Medicine and Metabolic Diseases, University
of
Naples, Italy.
Previous studies have shown that insulin has an important in vitro
role
in the regulation of human erythropoiesis.
We investigated whether in vivo hyperinsulinaemia/insulin resistance
affects haematological parameters.
A total of 608 subjects between 22 and 99 years of age were enrolled
in the Chianti study, an epidemiological study of factors affecting
mobility in old age.
The degree of insulin resistance was assessed using the homeostasis
model.
We found a correlation between insulin resistance and red blood cell
count,
(r = 0.14 p < 0.001), plasma haemoglobin (r = 0.16 p < 0.001),
haematocrit
(r = 0.15 p < 0.001) and plasma iron (r = 0.1 p < 0.05)
concentrations.
Red blood cell count was also associated with the other biological
markers
of insulin resistance syndrome.
Subjects with higher insulin resistance (4 degrees quartile) had
higher
red blood cell count, plasma triglycerides and low density
lipoproteins (LDL)
cholesterol concentrations and lower high density lipoproteins (HDL)
cholesterol concentrations then subjects at the lowest quartiles of
insulin resistance.
Insulin resistance and BMI were significant and independent predictors
of red
blood cell count even when the analysis was adjusted for age, sex,
waist-to-hip
ratio, plasma iron and drug intake.
Our findings provide in vivo evidence of a relation between
hyperinsulinaemia/insulin resistance, the main variables of insulin
resistance
syndrome and erythropoiesis.
Increased red blood cell count could be considered as a new aspect of
the insulin
resistance syndrome that could contribute to the increased risk of
developing
cardiovascular problems.
PMID: 11692171
Who loves ya.
Tom
Jesus Was A Vegetarian!http://tinyurl.com/2r2nkh
Man Is A Herbivore!http://tinyurl.com/4rq595
DEAD PEOPLE WALKINGhttp://tinyurl.com/zk9fk