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Vol. 41. Issue 2.
Pages 103 (April - June 2019)
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Vol. 41. Issue 2.
Pages 103 (April - June 2019)
Scientific Comment
DOI: 10.1016/j.htct.2019.03.002
Open Access
Scientific comment on: “Analysis of imatinib adherence in chronic myeloid leukemia: a retrospective study in a referral hospital in the Brazilian Amazon”. Who likes to take medicine forever?
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Israel Bendit
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isbendit@usp.br

Correspondence to:Laboratório de Biologia Tumoral do Serviço de Hematologia do HCFMUSP, Av. Dr. Enéas de Carvalho Aguiar, 155-1° andar, Cerqueira César, CEP: 05403000, São Paulo, SP, Brazil.
Serviço de Hematologia do Hospital das Clínicas da FMUSP, São Paulo, Brazil
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hematol Transfus Cell Ther. 2019;41:106-1310.1016/j.htct.2018.09.006
Alan Rodrigues Andrade, Daniel da Silva Leitão, Igor Penha Paz, Talitta Ribeiro Evangelista, Vanessa Joia de Mello, Moisés Hamoy
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In this issue of Hematology, Transfusion, and Cell Therapy Andrade et al.1 reported the analysis of imatinib adherence in 120 patients with chronic myeloid leukemia from a single institution. They follow those patients for almost a year (360 days) where 44.1% lived near the referred hospital, 20.8% up to 70km and the remaining cohort from 70 to more than 600km from the same hospital. The adherence was quantitated by PDC (Proportion of Days Counted) that is, in other words, the total number of days that medication was supplied by the total number of days of observation. Although this methodology is not very accurate for reasons mentioned by Andrade et al. that method is easy to apply and cost less. If PDC reached 80% or more, the patient was considered adherent otherwise nonadherent. The adherence and non-adherence to imatinib treatment was 77.5% and 22.5% respectively. The adherence or non-adherence did not correlate with the distance range from the origin to the hospital neither the scholarship level, age or gender. The main reasons for non-adherence when was identifiable were disinterest (37.5%), lack of medication (6.25%) and side effects (6.25%) resulting in the abandonment of treatment. The results presented by Andrade et al. are in concordance with other studies conducted in counties with a higher Human Development Index like Belgium, Britain, and Taiwan which showed 30%, 26%, and 27% of non-adherence respectively.2–4 The importance of that study although retrospective was to show that it is possible to conduct good clinical practice even in the most remote regions in Brazil that has continental characteristics.

References
[1]
A.R. Andrade, D.S. Leitão, I.P. Paz, T.R. Evangelista, V.J. de Mello, M. Hamoy.
Analysis of imatinib adherence in chronic myeloid leukemia: a retrospective study in a referral hospital in the Brazilian Amazon.
Hematol Transfus Cell Ther, 41 (2019), pp. 106-113
[2]
L. Noens, M.A. van Lierde, R. De Bock, G. Verhoef, P. Zachée, Z. Berneman, et al.
Prevalence, determinants, and outcomes of nonadherence to imatinib therapy in patients with chronic myeloid leukemia: the ADAGIO study.
Blood, 113 (2009), pp. 5401-5411
[3]
D. Marin, A. Bazeos, F.X. Mahon, L. Eliasson, D. Milojkovic, M. Bua, et al.
Adherence is the critical factor for achieving molecular responses in patients with chronic myeloid leucemia who achieve complete cytogenetic responses on imatinib.
J Clin Oncol, 28 (2010), pp. 2381-2388
[4]
T.C. Chen, L.C. Chen, Y.B. Huang, C.S. Chang.
Imatinib adherence associated clinical outcomes of chronic myeloid leukaemia treatment in Taiwan.
Int J Clin Pharm, 36 (2014), pp. 172-181

See paper by Andrade AR et al. on pages [106-113].

Copyright © 2019. Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular
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