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Adherence Is the Critical Factor for Achieving Molecular Responses in Patients With Chronic Myeloid Leukemia Who Achieve Complete Cytogenetic Responses on Imatinib

Open access
Marin, David, Bazeos, Alexandra, Mahon, Francois-Xavier, Eliasson, Lina, Milojkovic, Dragana, Bua, Marco, Apperley, Jane F., Szydlo, Richard, Desai, Ritti, Kozlowski, Kasia, Paliompeis, Christos, Latham, Victoria, Foroni, Letizia, Molimard, Mathieu, Reid, Alistair, Rezvani, Katy, de Lavallade, Hugues, Guallar, Cristina, Goldman, John, Khorashad, Jamshid S.·2010·Journal of Clinical Oncology

Abstract

Purpose: There is a considerable variability in the level of molecular responses achieved with imatinib therapy in patients with chronic myeloid leukemia (CML). These differences could result from variable therapy adherence. Methods: Eighty-seven patients with chronic-phase CML treated with imatinib 400 mg/d for a median of 59.7 months (range, 25 to 104 months) who had achieved complete cytogenetic response had adherence monitored during a 3-month period by using a microelectronic monitoring device. Adherence was correlated with levels of molecular response. Other factors that could influence outcome were also analyzed. Results: Median adherence rate was 98% (range, 24% to 104%). Twenty-three patients (26.4%) had adherence ≤ 90%; in 12 of these patients (14%), adherence was ≤ 80%. There was a strong correlation between adherence rate (≤ 90% or > 90%) and the 6-year probability of a 3-log reduction (also known as major molecular response [MMR]) in BCR-ABL1 transcripts (28.4% v 94.5%; P < .001) and also complete molecular response (CMR; 0% v 43.8%; P = .002). Multivariate analysis identified adherence (relative risk [RR], 11.7; P = .001) and expression of the molecular human organic cation transporter-1 (RR, 1.79; P = .038) as the only independent predictors for MMR. Adherence was the only independent predictor for CMR. No molecular responses were observed when adherence was ≤ 80% (P < .001). Patients whose imatinib doses were increased had poor adherence (86.4%). In this latter population, adherence was the only independent predictor for inability to achieve an MMR (RR, 17.66; P = .006). Conclusion: In patients with CML treated with imatinib for some years, poor adherence may be the predominant reason for inability to obtain adequate molecular responses.

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Metadata

Authors
Marin, D., Bazeos, A., Mahon, F.-X., Eliasson, L., Milojkovic, D., Bua, M., Apperley, J. F., Szydlo, R., Desai, R., Kozlowski, K., Paliompeis, C., Latham, V., Foroni, L., Molimard, M., Reid, A., Rezvani, K., de Lavallade, H., Guallar, C., Goldman, J., & Khorashad, J. S.
Venue
Journal of Clinical Oncology
Published
2010-05-10
Volume
28
Issue
14
Pages
2381-2388
ISSN
  • 0732-183X (ISSN-L)
  • 1527-7755
OpenAlex
W2166270808
Cited by
909
References
32
FWCI
43.82
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Adherence Is the Critical Factor for Achieving Molecular Responses in Patients With Chronic Myeloid Leukemia Who Achieve Complete Cytogenetic Responses on Imatinib. https://app.cochat.ai/papers/10.1200/jco.2009.26.3087
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Marin, D., Bazeos, A., Mahon, F.-X., Eliasson, L., Milojkovic, D., Bua, M., Apperley, J. F., Szydlo, R., Desai, R., Kozlowski, K., Paliompeis, C., Latham, V., Foroni, L., Molimard, M., Reid, A., Rezvani, K., de Lavallade, H., Guallar, C., Goldman, J., & Khorashad, J. S. (2010). Adherence Is the Critical Factor for Achieving Molecular Responses in Patients With Chronic Myeloid Leukemia Who Achieve Complete Cytogenetic Responses on Imatinib. Journal of Clinical Oncology. https://doi.org/10.1200/jco.2009.26.3087

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.