Regular medication is the foundation of long-term survival for patients with chronic granulocytes

  The basis for long-term survival of patients with chronic granulocytes is “early, regular and long-term medication”. It sounds like a simple requirement, but many patients do not pay attention to it, resulting in disease progression and life-threatening consequences.  As chronic granuloma is a hematologic malignancy, it is important to start taking medication as soon as possible after diagnosis.  The doctor will repeatedly emphasize that the drug must be eaten in sufficient quantity, eaten on time, and eaten for a long time. However, patients are still “confused” about how to take them. If you don’t remember during the clinic, you can take a look at the following dosing methods, using Imatinib as an example: ① Dosage: For adult patients with slow onset, the conventional dose is 4 capsules each time, once a day; take it with a meal and drink a large glass of water; the 4 capsules should not be split into different doses, as the concentration of the drug in the blood will decrease after splitting, and the efficacy will be reduced. The dose of medication for children needs to be calculated according to height and weight. It should be noted that children patients grow and develop faster and need to adjust the dose of medication accordingly in a timely manner, otherwise it may lead to long-term under-treatment and eventual deterioration of the disease; ② Long-term eating: In order for the disease to reach a long-term stable state, Imatinib, a class of drugs, needs to be taken for a long time. Patients should never stop the drug on their own, no matter how normal the blood test results look and how much the fusion gene quantification has dropped. The only person who can decide to reduce or even stop the medication is a qualified hematologist. Only by adhering to the medication as prescribed can the disease not progress and thus ensure long-term survival.  The prerequisite for discontinuation is strict adherence to the prescribed medication. Long-term imatinib use is costly and has an impact on quality of life, so patients with slow-growing granulocytes long for the day when they can stop taking the medication without their disease returning. Studies in recent years have confirmed that this desire has become a reality in some patients. After a “deep remission”, i.e. when the fusion gene quantification reaches a so-called MR 5.0 or higher (the so-called “discontinuation threshold”) and is maintained for more than two years, about 60% of patients can stop imatinib treatment and their disease remains stable. Approximately 40% of patients in deep remission experience disease relapse after discontinuation, but the study found that almost all of these patients who relapsed after discontinuation regained stable remission once oral imatinib therapy was started in a timely manner. While the information on discontinuation is encouraging, it is important to emphasize that such attempts should only be made in patients who reach the “discontinuation threshold” under close monitoring by a specialist. Therefore, in order to reach the “discontinuation threshold”, it is still necessary to emphasize strict dosage and full course of medication after diagnosis, and only if medical advice is strictly followed early on will it be possible to reach the “discontinuation threshold” and eventually make an attempt to discontinue the medication.  In order to prevent missed doses, patients are advised to prepare a special medication box with the seven days of the week in the corresponding compartment and check the medication status every night. Patients are also advised to take their medication regularly every day to develop a habit. Good treatment effect should be based on strict medication taking. If patients forget to take their medication in the morning, they can make up the medication at noon or afternoon according to the original dose, which will not affect the next day’s medication, but do not miss the medication as much as possible.