Supportive Care in Cancer

, Volume 26, Issue 2, pp 323–324 | Cite as

How to report adherence to treatment as clinically relevant data—making a case of CML and TKI

  • Lucas Miyake OkumuraEmail author
Letter to the editor

Adherence comes from the Latin word “adhaerere”, and implies to “remain constant”, to “keep close” or to “maintain” [1]. When this concept is brought to therapeutics, such as patients with chronic myeloid leukemia (CML) using tyrosine kinase inhibitors (TKI), the persistence of an individual to adhering to treatment is somehow simplified to self-referred and non-validated questionnaires [2].

Despite the interesting article from Moulin et al. about the role of clinical pharmacists on CML, which is one of the first from Latin America, adherence to TKI needs to evolve from over past concepts, such as simply dichotomizing adherence [3]. More consistent, practice-oriented and reproducible adherence methods are the keys to providing external and internal validation in CML studies [2]. This report aims to discuss how to address adherence to treatment as clinically relevant outcome, making a case of TKI and CML.

By taking a good example of HIV medications, one adherence tool (medication...



The author was given a monthly scholarship from the Brazilian Ministry of Education, by the time the letter was conceived (Residência Integrada Multiprofissional em Saúde).

Compliance with ethical standards

Conflict of interest

The author declares that there are no conflicts of interest.


  1. 1.
    Aronson JK (2007) Compliance, concordance, adherence. Br J Clin Pharmacol 63:383–384CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Breccia M, Efficace F, Alimena G (2012) Adherence to treatment is a complex and multifaceted issue that can substantially alter the outcome of chronic myeloid leukemia patients treated with tyrosine kinase inhibitors. Leuk Res 36:804–805CrossRefPubMedGoogle Scholar
  3. 3.
    Moulin SM, Eutrópio FJ, Souza JO et al (2017) The role of clinical pharmacists in treatment adherence: fast impact in suppression of chronic myeloid leukemia development and symptoms. Support Care Cancer 25:951–955CrossRefPubMedGoogle Scholar
  4. 4.
    Vrijens B, Goetghebeur E, de Klerk E et al (2005) Modelling the association between adherence and viral load in HIV-infected patients. Stat Med 24:2719–2731CrossRefPubMedGoogle Scholar
  5. 5.
    Okumura LM, Antunes VD, Aguiar KS et al (2015) Tyrosine kinase inhibitors in patients with chronic myelogeneous leukemia: defining the role of social risk factors and non-adherence to treatment. Pharm Pract (Granada) 13:559CrossRefGoogle Scholar
  6. 6.
    Guilhot J, Preudhomme C, Mahon FX et al (2015) Analyzing molecular response in chronic myeloid leukemia clinical trials: pitfalls and golden rules. Cancer 121:490–497CrossRefPubMedGoogle Scholar
  7. 7.
    Morisky DE, Ang A, Krousel-Wood M et al (2008) Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich) 10:348–354CrossRefGoogle Scholar
  8. 8.
    Gater A, Heron L, Abetz-Webb L et al (2012) Adherence to oral tyrosine kinase inhibitor therapies in chronic myeloid leukemia. Leuk Res 36:817–825CrossRefPubMedGoogle Scholar
  9. 9.
    Vrijens B, De Geest S, Hughes DA et al (2012) A new taxonomy for describing and defining adherence to medications. Br J Clin Pharmacol 73:691–705CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Ganesan P, Sagar TG, Dubashi B (2011) Nonadherence to imatinib adversely affects event free survival in chronic phase chronic myeloid leukemia. Am J Hematol 86:471–474CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Clinical Pharmacy DivisionHospital de Clínicas de Porto AlegrePorto AlegreBrazil

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