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Blood Volume - Dosing Question


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#1 bagdaddi

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Posted 27 September 2013 - 12:43 PM

Just a curiosity question that may be completely invalid...

If total blood volume is a function body weight, shouldn't this be taken into consideration when determining dosage?  A 6' tall, 150# man has roughly 5 liters of blood compared to 6.50 liters for this same man at 250#'s (approx. 30% difference).  Is the 150# man effectively receiving a 30% higher dose if they are both taking the same TKI dosage?



#2 jjg

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Posted 27 September 2013 - 10:35 PM

There are lots of factors that affect how much of the TKIs gets to the leukemic cells. Whilst blood volume probably plays a role it seems to be just a small role. At 5 ft 10" 120lb female I felt sure I would need less drug than average but when I was on 600mg glivec the trough concentration of the drug in my blood was less than average for people taking 400mg. Interestingly I still reached PCRU in 12 months.. Dosing seems to be start with what is known to be effective/safe and then suck it and see....although it tastes sooo disgusting I wouldn't recommend actually doing this. My docs approach was we can start you on 400 and see if you are able to/ need to go up or we can start you on 600 and see if you need to decrease. I chose 600 to optimise response (2nd gen drugs were not available).


Dx Dec 2010 @37

2x IVF egg collection

Glivec 600 & 800mg

PCRU March 2012

Unsuccessful pregnancy attempt - relapsed, 3 months interferon (intron A), bad side effects from interferon

Nilotinib 600mg Oct 2012

PCRU April 2013, 2 years MR4.5 mostly PCRU with a few blips

April 2015 stopped again for pregnancy attempt (donor egg), pregnant first transfer, 0.110 at 10wks, 2.1 at 14wks, 4.2 at 16wks, started interferon, slow dose increase to 25MIU per wk, at full dose PCR< 1 for remainder of pregnancy

Healthy baby girl Jan 2016, breastfed one month

Nilotinib 600mg Feb 2016

MMR May 2016

PCRU Feb 2017


#3 Trey

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Posted 28 September 2013 - 08:51 AM

Here is a previous discussion about this issue:

http://community.lls.org/message/19349






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