Importance of Adherence

For patients newly diagnosed with Ph+ CML in chronic phase, the estimated overall survival at 7 years is 86% with oral TKI therapy.¹ However, Ph+ CML can progress to accelerated phase (AP) and ultimately to blast crisis (BC).² Transition may occur gradually or abruptly. After the development of AP, survival is usually less than 1 year; after blastic transformation, survival is only a few months.³ Relapse is characterized by any evidence of progression from a stable remission, which may include²

• Increasing myeloid or blast cells in the blood or bone marrow
• Cytogenetic positivity after previous cytogenetic negativity
• Fluorescent in situ hybridization (FISH) positivity for BCR-ABL after previous BCR-ABL negativity

Oral TKI therapy has revolutionized treatment for patients with chronic-phase Ph+ CML.⁴ However, to prevent relapse, responding patients must continue therapy indefinitely.⁴ Strict adherence to therapy is also critically important. A recent prospective study shows that nonadherence to oral TKI therapy negatively impacts outcome for patients with chronic-phase Ph+ CML.⁵ This study indicates that nonadherence to oral TKI therapy⁵

• Is associated with lower treatment response
• Is more prevalent than patients, physicians, and family members realize
• Should be assessed routinely
• Can be recognized through determinants that can serve as warning signs

Next: Recent Studies: Adherence

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