The University of Texas M.D. Anderson Cancer Center, Department of Leukemia, Unit 428, 1515 Holcombe Blvd, Houston, TX 77030, USA.
Clin Lymphoma Myeloma Leuk. 2012 Aug;12(4):223-9. doi: 10.1016/j.clml.2012.04.002. Epub 2012 May 24.
Treatment for chronic myeloid leukemia (CML) has improved substantially in the past 20 years, especially since the introduction of oral BCR-ABL inhibitors a decade ago. However, for patients to reap the benefits of BCR-ABL inhibitors, they must likely receive therapy for the remainder of their lives. In this situation, adherence to medication becomes a concern. Adherence to therapy for chronic health conditions, including CML, has been demonstrated to be poor. Studies have shown nonadherence in CML to be common in one-third or more of patients, and 100% adherence is rare. Furthermore, evidence suggests that reduced adherence to BCR-ABL inhibitors is associated with reduced efficacy and increased healthcare costs. Factors that can cause nonadherence, including dose, toxicity, time from diagnosis to prescription, and the number of concomitant medications, should be addressed and monitored by the physician. To maximize adherence, CML treatment should be individualized to the patient and simplified as appropriate.
在过去的 20 年中，慢性髓性白血病（CML）的治疗已经有了显著改善，尤其是在十年前引入口服 BCR-ABL 抑制剂之后。然而，为了让患者从 BCR-ABL 抑制剂中获益，他们很可能需要终生接受治疗。在这种情况下，药物的依从性就成了一个问题。已经证明，包括 CML 在内的慢性疾病的治疗依从性很差。研究表明，三分之一或更多的患者存在 CML 治疗不依从的情况，而 100%的依从性很少见。此外，有证据表明，BCR-ABL 抑制剂的依从性降低与疗效降低和医疗保健成本增加有关。可以导致不依从的因素，包括剂量、毒性、从诊断到处方的时间以及同时服用的药物数量，都应该由医生解决和监测。为了最大限度地提高依从性，CML 治疗应该根据患者的情况进行个体化，并酌情简化。
