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Background: Adherence to Imatinib (Glivec®) is of critical importance in achieving optimal treatment outcomes in patients with chronic myeloid leukemia (CML). Objective: This study aims to investigate adherence to therapy and factors that could influence patient adherence to Glivec®. Methods: This is a prospective cohort study conducted at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile--Ife. Seventy consenting newly diagnosed CML patients in the chronic phase were counseled on adherence to therapy and administered 400 mg/day dose of Glivec. Six months after commencement, they were evaluated for adherence using two structured self--administered questionnaires. The first one to evaluate adherence (Morisky Medication Adherence Scale) and the other was administered to identify factors known to influence adherence to therapy. Data were analyzed using SPSS version 21.0 Statistical package (2012, IBM Corp, Armonk, NY, USA.). Results: The study participants had a mean age of 38.4 ± 12.7 years. The male--to--female (male:female) ratio was 1.7:1. Thirty--three (47.1%) of the patients were classified as adherent. Family support was significantly associated with adherence (P = 0.012). The distance of >200 km away from the point of drug collection, OAUTHC, Ile--Ife was significantly associated with nonadherence to Glivec therapy (P = 0.008). Conclusion: This study found that adherence in patients on Glivec® therapy was <50%. Distance of >200 km and family support were significant determinants of adherence in this study. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The advent of the tyrosine kinase inhibitors has markedly changed the prognostic outlook for patients with Ph+ and/or BCR-ABL1+ chronic myeloid leukemia (CML). This study was designed to assess the overall survival (OS) of Nigerian patients with CML receiving imatinib therapy and to identify the significant predictors of OS. METHODS: All patients with CML receiving imatinib from July 2003 to June 2013 were studied. The clinical and hematological parameters were studied. The Kaplan–Meier technique was used to estimate the OS and median survival. P-value of ,0.05 was considered as statistically significant. RESULTS: The median age of all 527 patients (male/female = 320/207) was 37 (range 10–87) years. There were 472, 47, and 7 in chronic phase (CP), accelerated phase, and blastic phase, respectively. As at June 2013, 442 patients are alive. The median survival was 105.7 months (95% confidence interval [CI], 91.5–119.9); while OS at one, two, and five years were 95%, 90%, and 75%, respectively. Multivariate Cox regression analysis revealed that OS was significantly better in patients diagnosed with CP (P = 0.001, odds ratio = 1.576, 95% CI = 1.205–2.061) or not in patients with anemia (P = 0.031, odds ratio = 1.666, 95% CI = 1.047–2.649). Combining these variables yielded three prognostic groups: CP without anemia, CP with anemia, and non-CP, with significantly different median OS of 123.3, 92.0, and 74.7 months, respectively (X2 = 22.042, P = 0.000016). CONCLUSION: This study has clearly shown that for Nigerian patients with CML, the clinical phase of the disease at diagnosis and the hematocrit can be used to stratify patients into low, intermediate, and high risk groups. [ABSTRACT FROM AUTHOR]