HDAC Inhibitors as Epigenetic Regulators

Dasatinib was used seeing that first line treatment by 14 patients, and 12 patients were shifted from imatinib to dasatinib as second line treatment. Statistical comparisons of different parameters between adherent and nonadherent groups were conducted. Fifty-eight patients were enrolled in this study, and 31% of them had poor adherence. The lack of information about treatment and medication was the major reason for poor medication adherence. Patients who were younger and unmarried were prone to poor adherence. The occurrence of side effects carried no statistically significant influence on adherence. Poor adherence resulted in a poor treatment response (lower 3-month early molecular response rate and lower 12-month major molecular response rate). Poor adherence is usually common in Taiwanese patients with CML. The main reason for a decrease in the adherence rate is the lack of comprehensive information about treatment and medication, particularly in young and single populace. The next urgent step is usually to educate patients about their treatment and management of side effects to improve adherence and treatment outcome for patients with CML in Taiwan. transcript levels, expressed as BCR-ABL1% around the SI (international system) models.[13] The 3-month early molecular response (EMR) rate and the 12-month major molecular response (MMR) rate were collected retrospectively from chart review as primary endpoints to evaluate the treatment response to Biperiden TKIs in our study. EMR is usually defined as BCR-ABL1 10% Biperiden and MMR is usually defined as BCR-ABL1 0.1%.[14] 2.4. Side effects evaluation The evaluation of side effects was classified as nonhematologic side effects and hematologic side effects. Nonhematologic side effects were obtained from the questionnaire provided to participants, and included skin rash, GI upset, edema, headache, myalgia, malaise, and pleural effusion. The hematologic side effects, such as leukopenia, anemia, and thrombocytopenia, were collected by chart and data review. 2.5. Statistical analysis Statistical comparisons of baseline characteristics, side effects, and answers to the 2 2 questions about adherence and nonadherence were conducted. The Student test or nonparametric statistics were utilized to test for statistically significant differences in continuous variables, while Chi-squared or Fisher exact tests were used for categorical variables. Logistic regression was also used to examine the predictors of the 3-month EMR rate and the 12-month MMR rate. Odds ratios (ORs) and their 95% confidence intervals (CIs) were presented for all those covariates included in the logistic regression model. All assessments were 2-sided and statistical significance was defined at em P /em ? ?.05. 3.?Results 3.1. Baseline characteristics and medication adherence in patients with CML A total of 58 out of 77 eligible patients who completed the survey were enrolled in this study (Fig. ?(Fig.1).1). Most patients were male (n?=?39, 67.2%), married (n?=?38, 65.5%), and had a high educational level (n?=?46, 79.3%). The median age was 50 years (range: 20C83 years). Among them, 23 patients (39.7%) had a Charlson comorbidity index of 0 points and 17 patients (29.3%) received at least 2 other concurrent drugs for comorbidities. The mean duration of TKI treatment was 5.27 years Rabbit Polyclonal to USP30 (standard deviation, 3.56 years). At the time of interview, 22 patients (47.9%) were receiving imatinib, 26 patients (44.8%) were receiving dasatinib, and only 10 (17.3%) patients were receiving nilotinib. Among the 26 patients who were receiving dasatinib, 14 patients used as the medication as first line treatment, 11 patients had dasatinib as second line treatment and shifted from imatinib due to suboptimal response or treatment failure, and 1 patient was shifted from nilotinib due to difficultly controlling hyperglycemia. Among the 10 patients who were receiving nilotinb, this was Biperiden first line treatment for 2 patients, second Biperiden line treatment for 7 patients who were shifted from imatinib due to suboptimal response or treatment failure, and 1 patient was shifted from dasatinib due to pleural effusion (Table ?(Table11). Open in a separate window Physique 1 Algorithm of patient recruitment. Table 1 Baseline characteristics of patients with chronic myeloid leukemia. Open in a separate windows The median adherence score measured by MMAS-8 was 6 (range 1C8), indicating medium adherence. The results of the study revealed that 17 (31.0%) patients showed high adherence, 23 (37.9%) showed medium adherence, and 18 (31.0%) showed low adherence; the latter was defined as nonadherence based on our definition. 3.2. Association between baseline characteristics and medication adherence From our study, older age ( em P /em ?=?.02) and married status ( em P /em ?=?.02) were found to be associated with better adherence. Other characteristics, such as sex, educational level, comorbidities, concomitant.