Poor drug compliance in an adolescent with leukemia.

Poor drug compliance in pediatric patients is a frustrating problem for it is common, difficult to document, and difficult to change. This report describes an adolescent who was found to be noncompliant in taking his therapy for acute lymphoblastic leukemia. 17kgs assay showed noncompliance with prednisone therapy three times--the third episode thwarting a reinduction attempt. Psychological testing was performed to assess factors that may have contributed to this noncompliance. This patient was found to have low anxiety, excess hostility, borderline intelligence, and a feeling that his fate was predetermined. Intervention therapy was attempted by additional counseling and education about the basic disease, but this was unsuccessful. Drug compliance was eventually achieved only through hospitalization. Identification of psychological factors and clinical situations associated with poor drug compliance is discussed.