title: Poor adherence is the main reason for loss of CCyR and imatinib failure for chronic myeloid leukemia patients on long-term therapy.
abstract: We studied the relation between adherence to imatinib measured with microelectronic monitoring systems and the probabilities of losing a complete cytogenetic response (CCyR) and of imatinib failure in 87 CCyR chronic myeloid leukemia patients receiving long-term therapy. We included in our analysis the most relevant prognostic factors described to date. On multivariate analysis, the adherence rate and having failed to achieve a major molecular response were the only independent predictors for loss of CCyR and discontinuation of imatinib therapy. The 23 patients with an adherence rate less than or equal to 85% had a higher probability of losing their CCyR at 2 years (26.8% vs 1.5%, P = .0002) and a lower probability of remaining on imatinib (64.5% vs 90.6%, P = .006) than the 64 patients with an adherence rate more than 85%. In summary, we have shown that poor adherence is the principal factor contributing to the loss of cytogenetic responses and treatment failure in patients on long-term therapy.
authors.affiliation: Department of Haematology, Imperial College London, Hammersmith Hospital, Du Cane Road, London, United Kingdom.
authors.forename: Amr R
authors.initials: AR
authors.lastname: Ibrahim
authors.forename: Lina
authors.initials: L
authors.lastname: Eliasson
authors.forename: Jane F
authors.initials: JF
authors.lastname: Apperley
authors.forename: Dragana
authors.initials: D
authors.lastname: Milojkovic
authors.forename: Marco
authors.initials: M
authors.lastname: Bua
authors.forename: Richard
authors.initials: R
authors.lastname: Szydlo
authors.forename: Francois-Xavier
authors.initials: FX
authors.lastname: Mahon
authors.forename: Kasia
authors.initials: K
authors.lastname: Kozlowski
authors.forename: Christos
authors.initials: C
authors.lastname: Paliompeis
authors.forename: Letizia
authors.initials: L
authors.lastname: Foroni
authors.forename: Jamshid S
authors.initials: JS
authors.lastname: Khorashad
authors.forename: Alex
authors.initials: A
authors.lastname: Bazeos
authors.forename: Mathieu
authors.initials: M
authors.lastname: Molimard
authors.forename: Alistair
authors.initials: A
authors.lastname: Reid
authors.forename: Katayoun
authors.initials: K
authors.lastname: Rezvani
authors.forename: Gareth
authors.initials: G
authors.lastname: Gerrard
authors.forename: John
authors.initials: J
authors.lastname: Goldman
authors.forename: David
authors.initials: D
authors.lastname: Marin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001549:Benzamides; D002869:Chromosome Aberrations / Q000187:drug effects / Q000706:statistics & numerical data; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D010879:Piperazines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D012074:Remission Induction; D013997:Time Factors; D017211:Treatment Failure
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate