Contributions
Abstract: EP683
Type: E-Poster Presentation
Session title: Chronic myeloid leukemia - Clinical
Background
Oral tyrosine kinase inhibitors (TKIs) are the standard of care for chronic myeloid leukemia (CML). TKIs are administered in an outpatient setting for an indefinite period which may negatively impact adherence. Non-adherence to TKIs is associated with disease progression.
Aims
This study was designed to determine the proportion of CML patients non-adherent to their TKIs regimen and their outcome. The secondary objective was to identify the influence of patient characteristics on TKIs adherence.
Methods
Cross-sectional retrospective chart and dispensing record reviews were performed to identify patients receiving a TKI (imatinib, nilotinib and dasatinib) from January 2012 to December 2018. Adherence was evaluated using the medication possession ratio.
Results
With a median follow-up of 72 months, 83 patients with CML were included in our study. 16 (19%) patients were considered non-adherent to treatment. At 18 months of treatment, a major molecular response (MMR) was obtained in 61 (73.5%) patients. The 5-year event-free survival (EFS) of adherent patients was better than those who did not adhere to TKIs: 86% vs 61% (p = 0.0039). The rate of MMR was higher in adherent patients: 89% vs 6% (p <0.0001). 7 (44%) of non-adherent patients had grade 3 or 4 TKIs toxicity (p <0.001), while a low level of education was found in 11 (69%, p = 0.01). After multivariate analysis, only the occurrence of severe side effects of TKIs was predictive of patient non-adherence.
Conclusion
Non-adherence to TKIs of patients with CML should always be considered as a cause of treatment failure. It requires a good therapeutic education of the patients, and a better management of TKIs side effects.
Keyword(s):
Abstract: EP683
Type: E-Poster Presentation
Session title: Chronic myeloid leukemia - Clinical
Background
Oral tyrosine kinase inhibitors (TKIs) are the standard of care for chronic myeloid leukemia (CML). TKIs are administered in an outpatient setting for an indefinite period which may negatively impact adherence. Non-adherence to TKIs is associated with disease progression.
Aims
This study was designed to determine the proportion of CML patients non-adherent to their TKIs regimen and their outcome. The secondary objective was to identify the influence of patient characteristics on TKIs adherence.
Methods
Cross-sectional retrospective chart and dispensing record reviews were performed to identify patients receiving a TKI (imatinib, nilotinib and dasatinib) from January 2012 to December 2018. Adherence was evaluated using the medication possession ratio.
Results
With a median follow-up of 72 months, 83 patients with CML were included in our study. 16 (19%) patients were considered non-adherent to treatment. At 18 months of treatment, a major molecular response (MMR) was obtained in 61 (73.5%) patients. The 5-year event-free survival (EFS) of adherent patients was better than those who did not adhere to TKIs: 86% vs 61% (p = 0.0039). The rate of MMR was higher in adherent patients: 89% vs 6% (p <0.0001). 7 (44%) of non-adherent patients had grade 3 or 4 TKIs toxicity (p <0.001), while a low level of education was found in 11 (69%, p = 0.01). After multivariate analysis, only the occurrence of severe side effects of TKIs was predictive of patient non-adherence.
Conclusion
Non-adherence to TKIs of patients with CML should always be considered as a cause of treatment failure. It requires a good therapeutic education of the patients, and a better management of TKIs side effects.
Keyword(s):