Evaluation of Imatinib adherence in chronic myeloid leukemia patients in Babylon Province, Iraq

Abstract

Background: Chronic myeloid leukemia is a clonal myeloproliferative neoplasm that results in proliferation, mainly of granulocytic components. Resulting from t(9;22) with fusion oncogen BCR-ABL1 which has uninhibited tyrosine kinase activity. The introduction of tyrosine kinase inhibitors, such as Imatinib, has significantly altered the management and prognosis of this condition, but poor adherence is still a significant factor in therapy failure. Objective: To measure chronic myeloid leukemia (CML) patients’ adherence to Imatinib treatment and to analyze potential reasons for poor adherence. Materials and Methods: The study included 52 CML patients in the chronic phase treated with Imatinib for at least 12 months; 30 of them were women and 22 were men, with a median age of 45 years. Patient adherence to Imatinib was assessed using the Morisky Medication adherence scale. Response to treatment was assessed by the evaluation of the level of BCR-ABL1 mutation in peripheral blood. Results: Out of 52 patients, 17 were adherent to Imatinib while 35 of them were nonadherent. The patient’s adherence status to Imatinib was found to have a significant effect on the response to treatment. The most common cause of nonadherence was forgetfulness. Age, sex, occupation, educational level, marital status, residence, duration of treatment, relation to meal time, taking other medications, and drug side effects have no significant effect on adherence. Conclusions: Adherence to Imatinib was poor and this has a negative impact on patients’ response to therapy. Patients’ forgetfulness was the most frequent reason for nonadherence, followed by drug-related patient disturbance.