Economic analysis of blood product transfusions according to the treatment of acute myeloid leukemia in the elderly

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• 作者：G. Cannas^a ; ^b ; J. Fattoum^a ; M. Boukhit^a ; X. Thomas^c ; ^{xavier.thomas@chu-lyon.fr" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Acute myeloid leukemia ; Therapy ; Blood transfusion ; Cost-effectiveness ; Prognosis
• 刊名：Transfusion Clinique et Biologique
• 出版年：2015
• 出版时间：October-December 2015
• 年：2015
• 卷：22
• 期：5-6
• 页码：341-347
• 全文大小：531 K

文摘

Blood transfusion requirement represents one of the most significant cost driver associated with acute myeloid leukemia (AML). Low-intensity treatments (low-dose cytarabine, hypomethylating agents) have the potential to reduce transfusion dependence, and improve health-related quality of life.

Patients and methods

We assessed the cost-effectiveness of treatment types regarding blood product transfusions in a cohort of 214 AML patients aged ≥ 70 years.

Results

Analyzes did not indicate any significant overall survival (OS) advantage of intensive chemotherapy comparatively to low-intensity treatment. The difference was significant when compared to best supportive care (BSC) (P < 0.0001). Blood products transfusion cost per patient was 1.3 times lower with low-intensity therapy and 2.7 times lower with BSC than with intensive chemotherapy. Mean transfusion cost per patient according to OS varied from 2.4 to 1.3 times less with low-intensity treatment comparatively to intensive chemotherapy for patients having OS ≤ 13.3 months. Costs varied from 3.5 to 2.6 times less with BSC comparatively to intensive chemotherapy. In contrast, mean transfusion costs were comparable among treatments for patients with OS > 13.3 months.

Conclusion

Low-intensity treatments represent a cost-effective alternative to BSC and require a reduced number of transfused blood products comparatively to intensive chemotherapy, while OS was not significantly different.