Nonadherence to acute lymphoblastic leukemia chemotherapy regimens in different geological and cultural contexts

Abstract

Nonadherence is a major clinical problem, with multiple causes, and can have negative medical, social, and economic effects. We describe two adolescent patients with acute lymphoblastic leukemia who were nonadherent to their oral maintenance regimens, and whose nonadherence could potentially cause fatal outcomes. Despite their geographical and cultural disparity (one patient lives in Japan and the other in Canada), both patients had similar reasons for nonadherence: insufficient understanding of the disease and its prognosis. Adolescence is a complicated time of life. It is also a known risk factor for nonadherence. Repeated education helped both patients comply with their medication schedules.