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Treatment adherence in chronic myeloid leukemia: a systematic review of the literature

Lina Eliasson

The introduction of the tyrosine kinase inhibitor (TKI) imatinib in the late 1990s, and the more recently licensed TKIs dasatinib and nilotinib, have essentially transformed chronic myeloid leukemia from a terminal illness with poor prognosis to a chronic illness that can be managed by the patient at home. The success of the treatment, however, is now reliant on the patients’ ability and motivation to adhere to the treatment as prescribed. Unfortunately many patients miss doses of their TKI treatment, which has been shown to have adverse consequences for individual patients’ treatment response as well as increase the associated healthcare costs. Nevertheless, it has been difficult to identify reliable predictors and explanations for why patients miss doses, making it a complex challenge to develop interventions to reduce nonadherence and improve outcomes in this patient group. This systematic review identified 17 different studies that have investigated adherence to TKI treatment in chronic myeloid leukemia patients and gives an overview of the knowledge that has been accumulated in this field up until June 2011.