Adherence and/or discontinuation of imatinib mesylate in patients with chronic myeloid leukemia

Alves, Alexandra Rodrigues; Lima, William Gustavo; Nagai, Michelly Martins; Rodrigues, Josemar; Ayres, Lorena Rocha

doi:10.1590/s1984-82502016000400001

Cited by 5 publications

(5 citation statements)

References 37 publications

(56 reference statements)

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“…Even small lapses in adherence can result in increased drug resistance and decreased likelihood of long-term event-free survival. 22,23 Therefore, approaches that promote increased adherence to TKI therapy are a crucial part of successful CML management.…”

Section: Discussionmentioning

confidence: 99%

“…Adherence to TKI therapy is critically important to achieve complete cytogenetic response to prevent disease progression in this patient population. Even small lapses in adherence can result in increased drug resistance and decreased likelihood of long-term event-free survival 22,23. Therefore, approaches that promote increased adherence to TKI therapy are a crucial part of successful CML management.…”

Section: Discussionmentioning

confidence: 99%

“…[16][17][18][19][20][21] Unfortunately, most adherence levels are 70% or lower with some even as low as 19%. 22,23 Therefore, effective interventions to improve adherence to TKI therapy are needed. The purpose of this systematic review was to explore studies that examined the impact of interventions or strategies to improve TKI adherence among individuals with CML.…”

Section: Introductionmentioning

confidence: 99%

“…An adequate adherence level to TKIs is between 80% and 90% 16–21. Unfortunately, most adherence levels are 70% or lower with some even as low as 19% 22,23. Therefore, effective interventions to improve adherence to TKI therapy are needed.…”

Section: Introductionmentioning

confidence: 99%

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Interventions to Improve Adherence to Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia

Heiney¹,

Sorrell

Sheng³

et al. 2021

American Journal of Clinical Oncology

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Background: Lack of adherence to tyrosine kinase inhibitors (TKIs) is a significant problem resulting in incomplete cytogenetic response and increased mortality in patients with chronic myeloid leukemia (CML). Few studies have been conducted on interventions to improve adherence. The authors conducted a systematic review to explore studies that examined the impact of strategies to improve TKI adherence among individuals with CML. Methods:The first 2 authors completed a systematic literature review according to the guidelines in Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Studies (n = 2633) conducted between 1980 and 2019 were identified through 3 databases and examined for inclusion/exclusion criteria.Results: Fourteen studies were identified which met the eligibility criteria. The studies only examined adherence to imatinib, dasatinib, or nilotinib. Ten of the 14 used large data sets (commercial health insurance plans or Surveillance Epidemiology and End Results [SEER] data) for analysis. The majority of the studies used a cohort design. Adherence was defined and measured in a variety of ways with most studies using 80% or higher as adequate adherence. Strategies not focused on health care costs used a multidisciplinary team approach.Conclusion: Development of evidence to improve treatment adherence to TKIs for CML have relied on large data sets rather than prospective trials. Current studies lack patient focused interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Interventions to Improve Adherence to Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia

Heiney¹,

Sorrell

Sheng³

et al. 2021

American Journal of Clinical Oncology

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“…In contrast to parenteral chemotherapy, which is given under the health care provider supervision, oral chemotherapy is highly dependent on the patient's commitment [6]. The systematic review of 14 articles regarding adherence to IM used in CML patients showed therapeutic adherence varies widely, ranging from 19 to 97% [7]. Adherence is a strong predictor of achieving an adequate molecular response in CML patients treated…”

Section: Introductionmentioning

confidence: 99%

Quality of Life and Adherence to Imatinib Mesylate Therapy in Chronic Myeloid Leukemia Patients at Dharmais Cancer Hospital Jakarta

Virginia

Radji

Andalucia

2021

Indonesian Journal of Cancer

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Background: Quality of life and adherence to long-term imatinib mesylate (IM) therapy is a major factor in achieving therapeutic effects in patients with chronic myeloid leukemia (CML). However, the data of the quality of life and adherence level is inconsistent in various studies and is also not fully understood yet in Indonesia. Methods: This is an observational study (single-centered) using a cross-sectional design. CML patients older than 18 years old with National Health Insurance (JKN) at the Dharmais Cancer Hospital (RSKD) Jakarta who used IM for at least one month were tested using the Medication Adherence Questionnaire (MAQ) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) from March to April 2020.Result: A total of 50 CML patients were included in the study (male: female ratio = 1.08: 1), had a good median score of global health status/QoL, and had a good function and symptom scales, except for the fatigue symptom scale (median: 33.33; 25th percentile - 75th percentile: 11.11– 44.44). The patient adherence rate was dominated by adherent patients (20/50; 40.0%). Comparative analysis revealed that the scale of QoL (p = 0.028) and fatigue (p = 0.094) variables showed statistically significant differences between adherent and non-adherent subjects.Conclusions: This study showed that two-fifth of patients were considered to be non-adherent. Adherent patients were known to have higher QoL than non-adherent patients. Meanwhile, patients with severe symptoms of fatigue were found to be non-adherent to IM therapy.

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Molecular response to imatinib in patients with chronic myeloid leukemia in Tanzania

Nasser

Hussein²,

Chamba

et al. 2021

Blood Advances

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Imatinib is the mainstay of treatment of patients with chronic myeloid leukemia (CML) in Tanzania. Monitoring molecular response to therapy by real-time polymerase chain reaction at defined milestones is necessary for early detection of treatment failure. However, this assay is not routinely performed in Tanzania; therefore, the depth of molecular response among patients with CML is not known. A total of 158 patients with previously diagnosed CML who received imatinib treatment were recruited from January 2019 and followed up through October 2020 at Ocean Road Cancer Institute. Information was obtained at the time of diagnosis and follow-up. Blood samples were collected in EDTA tubes to measure the BCR/ABL ratio on the Gene Xpert system for molecular response determination. The median age of the 158 adult patients was 45 years (range, 18-86). By reference to established treatment milestones, only 37 (23.4%) achieved optimal molecular response. Signs of advanced-stage disease, in particular the need for red cell transfusions before diagnosis (adjusted odds ratio [AOR], 3.4; 95% CI, 1.32-9.17) and cytopenias (AOR, 2.26; 95% CI, 1.03-4.96) necessitating drug interruptions were statistically validated predictors of treatment failure on multivariate, multinomial logistic regression. Patient survival at the 22-month follow-up was lowest, with 78.6% (95% CI, 69.4-85.4) in the failure-to-respond category and highest in patients achieving optimal response 97.0% (95% CI, 80.9-99.6). In summary, the majority of patients with CML treated with imatinib in Tanzania do not obtain deep molecular response. This outcome can be attributed to late diagnosis, the development of cytopenias requiring multiple drug interruptions, and poor adherence to treatment.

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Adherence and/or discontinuation of imatinib mesylate in patients with chronic myeloid leukemia

Cited by 5 publications

References 37 publications

Interventions to Improve Adherence to Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia

Interventions to Improve Adherence to Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia

Quality of Life and Adherence to Imatinib Mesylate Therapy in Chronic Myeloid Leukemia Patients at Dharmais Cancer Hospital Jakarta

Molecular response to imatinib in patients with chronic myeloid leukemia in Tanzania

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