ORIGINAL ARTICLE The role of clinical pharmacists in treatment adherence: fast impact in suppression of chronic myeloid leukemia development and symptoms Silmara Mendes Martins Moulin 1 & Frederico Jacob Eutrópio 2 & Jessica de Oliveira Souza 1 & Fernanda de Oliveira Busato 3 & David N. Olivieri 4 & Carlos Eduardo Tadokoro 1,3 Received: 19 May 2016 /Accepted: 7 November 2016 # Springer-Verlag Berlin Heidelberg 2016 Abstract Purpose Chronic myeloid leukemia (CML) is a clonal myelo- proliferative disease, accounting for 15 to 20% of leukemias, with an incidence of one to two cases/100,000 inhabitants. In Brazil, the estimated incidence of leukemia is six cases/100,000 men and 4.28 cases/100,000 women. CML is characterized by the presence of the Philadelphia chromosome. At present, three types of tyrosine kinase inhibitors (TKI) are administered to treat CML patients in the Brazilian public national health system (NHS), called the Unified Health System (in Portuguese, BSistema Único de Saúde^, SUS). Such treatments are only ef- fective if patients adhere to strict dosage regimens; protocol im- provements that increase patient adherence to treatment would have economic and health benefits for overburdened health care systems. Here, pharmacist-monitored treatment is assessed. Methods In our study, we applied two questionnaires, one to assess the adherence to pharmacological treatment and another to assess the quality of life. All patients studied (n = 23) were diagnosed with CML at a local hospital in BEspírito Santo^ State, the BHospital Evangélico Vila Velha^ (HEVV). Results Treatment adherence was significantly higher in pharmacist-monitored patients than in nonmonitored patients (p = 0.0135). The quality of life of CML patients was also analyzed, indicating that monitored patients had a lower num- ber of symptoms/complaints during treatment periods than nonmonitored patients. Finally, improved treatment adherence also translated into better clinical conditions, particularly dur- ing the early stage of treatment (e.g., the first 4 months). Conclusions The intervention of a clinical pharmacist is sig- nificant to obtain positive clinical results. Therefore, it is rec- ommended that this protocol be included in the standard NHS treatment protocol CML patient outcomes to reduce the indi- rect and recurring costs to the health care system caused by nonadherence. Keywords Monitoring . Cancer . Hospital pharmacy . Pharmaceutical intervention Introduction Accumulated experimental and clinical evidence shows that the etiology of the hematological disorder, chronic myeloid leuke- mia, or chronic myelogenous leukemia (CML) is due to two factors: an excessive proliferation of cells from the myeloid lineage and the presence of the Philadelphia (Ph) chromosome [1]. The occurrence of the Ph chromosome is due to a reciprocal translocation between chromosomes 9 and 22 [2]. The result is a fused gene that joins the c-Abl exons 2–11 (chromosome 9) with the Bcr exons 1–2 (or 3) from chromosome 22, producing a final 210 kDa Bcr-Abl oncogene containing 902 to 927 amino Electronic supplementary material The online version of this article (doi:10.1007/s00520-016-3486-6) contains supplementary material, which is available to authorized users. * Carlos Eduardo Tadokoro carlos.tadokoro@uvv.br 1 Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF), Universidade Vila Velha, R. José Mauro de Vasconcelos, s/n, Laboratory of Immunobiology, room #33, Vila Velha, ES 29107-530, Brazil 2 Programa de Pós-Graduação em Ecologia de Ecossistemas (PPGEE, UVV), Instituto Capixaba de Ciência e Administração (ICCA), Vila Velha, ES, Brazil 3 Laboratory of Immunobiology, Universidade Vila Velha, Vila Velha, ES, Brazil 4 Escuela Superior de Ingeniería Informatica, University of Vigo, Vigo, Spain Support Care Cancer DOI 10.1007/s00520-016-3486-6