Importance of adherence to BCR-ABL tyrosine-kinase inhibitors in the treatment of chronic myeloid leukemia

Abstract

Treatment of chronic myeloid leukemia with BCR-ABL tyrosine kinase inhibitors requires full adherence in order to maximize the likelihood of achieving optimal responses, and to minimize healthcare costs. In this article, we review some of the methods available for assessing compliance, the main consequences of nonadherence on treatment outcomes, major factors commonly associated with poor compliance, a few successful measures for improving adherence and the most accepted recommendations for proactively managing adverse events.© 2014 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda. All rights reserved.

Drivers and Barriers to Medication Adherence in Patients with Chronic Myeloid Leukaemia: A Qualitative Study

“…Previous studies These factors are all known drivers to adherence along with longer disease duration, fear of the consequences of not adhering, using concurrent medication, having social support and using systems of reminders. Our results also confirm previous study results that relate higher levels of adherence to higher perceived functional status and QOL, including ability to work, and low burden of symptoms and side effects [3,6,7,11,12,14,26,[28][29][30][31]33,35,38]. Our participants described their role functioning as crucial to uphold a positive self-image and normality, which they felt was vital to a meaningful life.…”

“…'the extent of conformity to the recommendations about day to day treatment by the provider with respect to timing, dosage and frequency' [3] is crucial to achieve optimal treatment response [6][7][8]11,12,17,[26][27][28][29][30][31]32]. Yet the fact that CML has become a manageable chronic disease with much improved quality of life (QoL) may challenge adherence [4,8,26].…”

“…Non-adherence has also been linked to lacking knowledge about CML and treatment, co-payment, poor communication from health care providers and complacency due to sustained disease control [2][3][4]6,7,[10][11][12]14,17,19,[26][27][28][29][30][31][32][35][36][37][38][39]. Results diverge about adherence and type of TKI and may relate to the drug as well as patients' experiences with earlier treatments [7,8,19].…”

“…Yet the fact that CML has become a manageable chronic disease with much improved quality of life (QoL) may challenge adherence [4,8,26]. Non-adherence in up to 25-30% of CML patients have been suggested [4,7,19,[26][27][28]30,33]. Side effects are the most frequent reason for intentional non-adherence and has been associated with a negative impact on activities such as travels, other illness, psycho-social well-being and QoL [3,4,6,7,[9][10][11][13][14][15]17,26,29,31,33,34].…”

Induction of Heme Oxygenase-1 by Na+-H+ Exchanger 1 Protein Plays a Crucial Role in Imatinib-resistant Chronic Myeloid Leukemia Cells

“…2 is characterized by the presence of the Philadelphia chromosome, which forms as a result of a reciprocal translocation between chromosomes 9 and 22 and leads to production of the BCR-ABL1 fusion protein (1)(2)(3). The first BCR-ABL1 tyrosine kinase inhibitor, imatinib (IM), has been recommended for the first-line treatment of chronic phase CML and has dramatically increased survival rates since its introduction (4 -6).…”