{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T15:56:31Z","timestamp":1773417391438,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2012,1,6]],"date-time":"2012-01-06T00:00:00Z","timestamp":1325808000000},"content-version":"vor","delay-in-days":857,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2009,9]]},"abstract":"<jats:p>Imatinib is widely used to treat chronic myeloid leukemia and gastrointestinal stromal tumors. The agent, administered orally, has approximately 98% oral bioavailability, achieves maximum plasma concentration approximately 2\u20134 hours after ingestion, and has a plasma half\u2010life of approximately 18 hours. As maintaining an adequate plasma imatinib concentration is essential to achieving a favorable therapeutic response, it is important to determine whether gastrointestinal surgery, pathologic conditions, or anatomic changes negatively affect imatinib absorption, and thereby result in subtherapeutic plasma imatinib concentrations. We describe a 36\u2010year\u2010old, morbidly obese woman with chronic myeloid leukemia who received treatment with \u03b1\u2010interferon and cytarabine over 5 years. Her chemotherapy was then switched to imatinib 400 mg\/day because she failed to achieve a molecular response with the other two agents. A complete molecular response was achieved with imatinib. Four years later, she underwent a sleeve gastrectomy while receiving imatinib. Imatinib plasma pharmacokinetic values were assessed before and on four occasions during the year after the sleeve gastrectomy. The patient's trough plasma concentration before surgery (1558 ng\/ml) was consistent with those found in the literature (\u2264 1000 ng\/ml), whereas her trough concentrations after surgery were 46\u201360% lower (629\u2013836 ng\/ml) than the preoperative value. Despite this, the patient remained in complete molecular remission for 1 year after surgery. Monitoring plasma imatinib concentrations is recommended in morbidly obese patients with chronic myeloid leukemia or gastrointestinal stromal tumors who undergo gastric procedures. Additional pharmacokinetic studies, however, are needed in these patients.<\/jats:p>","DOI":"10.1592\/phco.29.9.1152","type":"journal-article","created":{"date-parts":[[2009,8,21]],"date-time":"2009-08-21T10:31:15Z","timestamp":1250850675000},"page":"1152-1156","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Imatinib Mesylate Pharmacokinetics Before and After Sleeve Gastrectomy in a Morbidly Obese Patient with Chronic Myeloid Leukemia"],"prefix":"10.1002","volume":"29","author":[{"given":"Carolina","family":"Pavlovsky","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merrill J.","family":"Egorin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhvani D.","family":"Shah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan H.","family":"Beumer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Rogel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santiago","family":"Pavlovsky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,1,6]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa020461"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200104053441402"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200104053441401"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-10-116475"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-07-036012"},{"key":"e_1_2_1_7_2","unstructured":"DemetriGD WangY WehrleE BlankeC JoensuuH vonMehrenM.Correlation of imatinib plasma levels with clinical benefit in patients (Pts) with unresectable\/metastatic gastrointestinal stromal tumors (GIST). Presented at the American Society of Clinical Oncology gastrointestinal cancers symposium Orlando Florida 2008."},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0091270003262101"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.03.050"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200544090-00001"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00280-008-0730-x"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00280-004-0876-0"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2005.02372.x"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/33.5.1070"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/106002809402800726"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.20049"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1570-0232(03)00206-X"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-05-2596"},{"key":"e_1_2_1_19_2","volume-title":"ADAPT II user's guide: pharmacokinetic\/pharmacodynamic systems analysis software","author":"D'Argenio DZ","year":"1997"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-10-116475"},{"key":"e_1_2_1_21_2","doi-asserted-by":"publisher","DOI":"10.1592\/phco.26.7.903"},{"key":"e_1_2_1_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00280-008-0778-7"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1592%2Fphco.29.9.1152","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1592\/phco.29.9.1152","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T09:55:40Z","timestamp":1761040540000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1592\/phco.29.9.1152"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,9]]},"references-count":21,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2009,9]]}},"alternative-id":["10.1592\/phco.29.9.1152"],"URL":"https:\/\/doi.org\/10.1592\/phco.29.9.1152","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,9]]},"assertion":[{"value":"2012-01-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}