Cost-effectiveness of a transplantation strategy compared to melphalan and prednisone in younger patients with multiple myeloma.

Abstract:

:High dose chemotherapy with autologous stem cell transplantation (ASCT) improves outcomes in patients 65 years of age or less with multiple myeloma. Survival and costs in a cohort of 16 patients who received melphalan and prednisone as part of a clinical trial were compared with those of 36 patients referred to our centre for consideration of ASCT. In the transplant group, survival and costs were extrapolated to match the period of observation in the melphalan and prednisone group. Patient-specific and average costs were calculated from the perspective of the Ontario Ministry of Health. Costs and survival were varied by 50% in the sensitivity analysis. Transplantation improved life expectancy by 19.3 months with a cost difference of 30,517 Canadian dollars. The incremental cost-effectiveness of transplantation compared with melphalan and prednisone was 25,710 Canadian dollars per life-year gained when additional pamidronate and follow-up costs were considered. Discounting costs and survival at 3 and 5% did not result in important differences. The sensitivity analysis resulted in best and worse case scenarios for transplantation compared with melphalan and prednisone of 13,049 dollars and 63,954 dollars per life-year gained respectively. In comparison with melphalan and prednisone, ASCT appears to be cost-effective in patients 65 years old or younger with myeloma.

journal_name

Leuk Lymphoma

journal_title

Leukemia & lymphoma

authors

Kouroukis CT,O'Brien BJ,Benger A,Marcellus D,Foley R,Garner J,Ingram C,Haines P,Henderson-O'Connor N,Meyer R

doi

10.3109/10428190309178811

keywords:

subject

Has Abstract

pub_date

2003-01-01 00:00:00

pages

29-37

issue

1

eissn

1042-8194

issn

1029-2403

journal_volume

44

pub_type

临床试验,杂志文章,随机对照试验
  • Biological response modifiers render tumor cells susceptible to autologous effector mechanisms by influencing adhesion receptors.

    abstract::Adhesion molecules such as CD2 and its ligand CD58 (LFA-3), as well as CD11a/18 (LFA-1) and CD54 (ICAM-1) regulate not only cell to cell attachment but also participate in lymphocyte activation, recirculation, and effector function including cytolytic activity towards tumor cells. We have investigated the role of CD2/...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章

    doi:10.3109/10428199309147353

    authors: Schirren CA,Völpel H,Hoffmann JC,Henning SW,Qiao L,Autschbach F,Dengler TJ,Döhner H,Meuer SC

    更新日期:1993-05-01 00:00:00

  • T-cell and NK/T-cell lymphomas in southern Taiwan: a study of 72 cases in a single institute.

    abstract::In an attempt to better understand the clinicopathologic features of T- and natural killer (NK)/T-cell lymphomas in Taiwan and the distribution and relative frequency of each subtype according to the new WHO classification, the pathology file of a medical center in southern Taiwan during 1989-2002 was retrospectively ...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章

    doi:10.1080/10428190310001625881

    authors: Lu D,Lin CN,Chuang SS,Hwang WS,Huang WT

    更新日期:2004-05-01 00:00:00

  • Pruritus in pediatric non-Hodgkin's lymphoma.

    abstract::A two-year-old girl presented with a 3-month history of generalized pruritus. One week before hospitalization she developed a superior vena cava syndrome and obstruction of the upper airways. Clinical and laboratory findings included generalized lymphadenopathy, a mediastinal mass compressing the tracheal lumen to the...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章

    doi:10.1080/1042819021000006330

    authors: Vècsei A,Attarbaschi A,Krammer U,Mann G,Gadner H

    更新日期:2002-09-01 00:00:00

  • Familial erythroleukemia: a distinct clinical and genetic type of familial leukemias.

    abstract::A family with erythroleukemia is presented, in which father and son were diagnosed at the same age, but 20 years apart, with almost identical clinical and morphological features of the disease. No environmental factors were identified. The karyotypic abnormalities of the bone marrow blasts in the son demonstrated 2 ma...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章,评审

    doi:10.3109/10428199809057551

    authors: Novik Y,Marino P,Makower DF,Wiernik PH

    更新日期:1998-07-01 00:00:00

  • Interdigitating dendritic cell sarcoma: a rare malignancy responsive to ABVD chemotherapy.

    abstract::Interdigitating dendritic cell sarcoma (IDCS) is an aggressive neoplasm of which fewer than 25 cases have been reported in the world literature. This malignancy is difficult to diagnose because of its rarity, and because of the subtle histopathologic features that distinguish IDCS from similar tumors arising from reti...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章

    doi:10.1080/10428190290016944

    authors: Olnes MJ,Nicol T,Duncan M,Bohlman M,Erlich R

    更新日期:2002-04-01 00:00:00

  • Superior outcome of patients with favorable-risk acute myeloid leukemia using consolidation with autologous stem cell transplantation.

    abstract::Autologous stem cell transplantation (ASCT), intensifying anti-leukemic effects without significant treatment-related mortality (TRM), is particularly appealing in AML with favorable genetic/molecular profile. This study retrospectively evaluated the outcomes of post-remission treatment in consecutive favorable-risk A...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章

    doi:10.1080/10428194.2019.1594214

    authors: Beyar-Katz O,Lavi N,Ringelstein-Harlev S,Henig I,Yehudai-Ofir D,Haddad N,Fineman R,Ofran Y,Nov Y,Sahar D,Moustafa-Hawash N,Rowe JM,Zuckerman T

    更新日期:2019-10-01 00:00:00

  • Predictive value of karyotype on outcome of autotransplants for acute myeloid leukemia in second remission.

    abstract::The impact of karyotype on the outcome of patients who undergo autotransplant for acute myeloid leukemia (AML) in second remission (CR2) has not been explored. We evaluated the outcomes of 40 patients who proceeded to autotransplant for AML in CR2 at 2 centers. The median age at autotransplant was 50 years (18-64 year...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章,多中心研究

    doi:10.1080/10428190400025112

    authors: Song KW,Mollee PN,Hogge DE,Gupta V,Barnett MJ,Forrest DL,Lavoie JC,Nevill TJ,Nantel SH,Shepherd JD,Smith CA,Sutherland HJ,Toze CL,Crump M,Keating A

    更新日期:2005-04-01 00:00:00

  • Dose-reduced combination of mitoxantrone, etoposide, and cytarabine (miniMEC) for relapsed and refractory acute leukemia.

    abstract::The combination of mitoxantrone (MIT), etoposide (ETP), and cytarabine (Ara-C) (MEC) is a frequently used salvage therapy for acute leukemia, but has been associated with severe myelosuppression. Therefore, we investigated the miniMEC regimen with reduced doses of AraC and MIT. Thirteen ALL and 44 AML patients, all re...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章

    doi:10.3109/10428194.2016.1153087

    authors: Yamamoto C,Ito S,Mashima K,Umino K,Minakata D,Yamasaki R,Kawasaki Y,Sugimoto M,Nakano H,Ashizawa M,Okazuka K,Hatano K,Sato K,Oh I,Fujiwara S,Ohmine K,Suzuki T,Muroi K,Kanda Y

    更新日期:2016-11-01 00:00:00

  • Idiopathic myelofibrosis associated with primary biliary cirrhosis.

    abstract::A patient with primary biliary cirrhosis (PBC) who developed idiopathic myelofibrosis (IM) is reported. The initial diagnosis of PBC was established by liver biopsy, performed after a 2-month history of constitutional symptoms associated with abnormalities of the serum liver enzymes, with typical serum immunological m...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章

    doi:10.1080/10428190290012272

    authors: Hernández-Boluda JC,Jiménez M,Rosiñol L,Cervantes F

    更新日期:2002-03-01 00:00:00

  • Genomic stratification of multiple myeloma treated with novel agents.

    abstract::Cytogenetic testing is now routinely performed for the prognostic work-up of multiple myeloma (MM). The abnormalities del(17p), t(4;14) and del(13q) have been established as predictors of poor outcome in patients with MM treated with conventional chemotherapy or stem cell transplant; chromosome 1q gains and 1p losses ...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章,评审

    doi:10.3109/10428194.2011.608449

    authors: Jiang A,Reece D,Chang H

    更新日期:2012-02-01 00:00:00

  • Nuclear transcription factor-kappaB in Hodgkin's disease.

    abstract::Nuclear factor-kappaB (NF-kappaB) is a transcriptional factor that was originally discovered in the nucleus of B cells that bind to the kappa light chain of the immunoglobulins. Research during 15 years, however, has revealed that NF-kappaB is present in its inactive state in the cytoplasm of almost every cell type. W...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章,评审

    doi:10.1080/1042819031000067558

    authors: Younes A,Garg A,Aggarwal BB

    更新日期:2003-06-01 00:00:00

  • A phase III study of anti-B4-blocked ricin as adjuvant therapy post-autologous bone marrow transplant: CALGB 9254.

    abstract::Anti-B4-blocked ricin (anti-B4-bR) is a potent immunotoxin directed against the CD19 antigen. Previous phase I and II studies suggested a possible role for anti-B4-bR as consolidation after high-dose chemotherapy and autologous stem cell transplant. Cancer and Leukemia Group B (CALGB) 9254 is a phase III study which r...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.3109/10428194.2010.543714

    authors: Furman RR,Grossbard ML,Johnson JL,Pecora AL,Cassileth PA,Jung SH,Peterson BA,Nadler LM,Freedman A,Bayer RL,Bartlett NL,Hurd DD,Cheson BD,Cancer Leukemia Group B.,Eastern Cooperative Oncology Group.

    更新日期:2011-04-01 00:00:00

  • Deletion of CDKN2A/B is associated with inferior relapse free survival in pediatric B cell acute lymphoblastic leukemia.

    abstract::Considering conflicting data on CDKN2A/B deletion in ALL, this study to assess its prognostic significance as an independent marker in a total of 96 pediatric B and T-ALL cases was planned. The overall frequency of CDKN2A/B deletion was 44% (n = 43) with 36% (30/83) in B-ALL and 100% (13/13) in T-ALL. CDKN2A/B deletio...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章

    doi:10.1080/10428194.2018.1482542

    authors: Kathiravan M,Singh M,Bhatia P,Trehan A,Varma N,Sachdeva MS,Bansal D,Jain R,Naseem S

    更新日期:2019-02-01 00:00:00

  • Health-related quality of life in survivors of lymphoma: a systematic review and methodological critique.

    abstract::Survival rates for Hodgkin lymphoma and non-Hodgkin lymphoma have improved in recent years. However, these improvements are associated with various late effects, which can compromise health-related quality of life (HRQoL). Improving HRQoL is a significant goal in oncology, and increasingly one of the primary outcomes ...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章,评审

    doi:10.3109/10428191003587263

    authors: Arden-Close E,Pacey A,Eiser C

    更新日期:2010-04-01 00:00:00

  • Efficacy and safety of gemtuzumab ozogamicin in patients with poor-prognosis acute myeloid leukemia.

    abstract::The objective of this work was to determine the safety and efficacy of gemtuzumab ozogamicin in patients with poor prognosis acute myeloid leukemia (AML). Patients with the following diagnoses/characteristics were treated with 1-3 infusions of gemtuzumab ozogamicin at a dose of 9 mg/m2: (1) relapse of AML < or = 6 mon...

    journal_title:Leukemia & lymphoma

    pub_type: 临床试验,杂志文章

    doi:10.1080/1042819021000016078

    authors: Roboz GJ,Knovich MA,Bayer RL,Schuster MW,Seiter K,Powell BL,Woodruff RD,Silver RT,Frankel AE,Feldman EJ

    更新日期:2002-10-01 00:00:00

  • Mimic of manganese superoxide dismutase induces apoptosis in human acute myeloid leukemia cells.

    abstract::Abstract Increasing manganese superoxide dismutase (MnSOD) expression can suppress the malignant phenotype in various cancer cell lines and suppress tumor formation in xenograft and transgenic mouse models. A mimic of manganese superoxide dismutase (MnSODm), synthesized by a chemical method, has been shown to possess ...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章

    doi:10.3109/10428194.2013.825904

    authors: Wang YH,Xu XJ,Zhang LF,Li HL

    更新日期:2014-05-01 00:00:00

  • Patterns of use of 18-fluoro-2-deoxy-D-glucose positron emission tomography for initial staging of grade 1-2 follicular lymphoma and its impact on initial treatment strategy in the National Comprehensive Cancer Network Non-Hodgkin Lymphoma Outcomes databa

    abstract::We describe the patterns of use of 18-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) for the initial staging of patients with newly diagnosed grade 1-2 follicular lymphoma (FL) and its potential impact on treatment. Data were obtained from the National Comprehensive Cancer Network Non-Hodgkin Lymphoma...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章,多中心研究

    doi:10.3109/10428194.2013.770151

    authors: Abou-Nassar KE,Vanderplas A,Friedberg JW,Abel GA,Niland J,Rodriguez MA,Czuczman MS,Millenson M,Crosby A,Gordon LI,Zelenetz AD,Kaminski M,Lacasce AS

    更新日期:2013-10-01 00:00:00

  • Diversity in antibody-based approaches to non-Hodgkin lymphoma.

    abstract::Non-Hodgkin lymphoma (NHL) remains one of the most common cancers in the US, with survival dependent on the type and stage of disease. B-cell lymphomas account for approximately 85% of all cases of NHL, and are commonly treated with chemotherapy, or monoclonal antibodies (mAbs) that target CD20 antigens on the surface...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章,评审

    doi:10.3109/10428194.2010.500047

    authors: Maloney D,Morschhauser F,Linden O,Hagenbeek A,Gisselbrecht C

    更新日期:2010-08-01 00:00:00

  • Combined therapeutic efficacy of the thymidylate synthase inhibitor ZD1694 (Tomudex) and the immunotoxin B43(anti-CD19)-PAP in a SCID mouse model of human B-lineage acute lymphoblastic leukemia.

    abstract::The quinazoline antifolate N-(5-[N-(3,4-dihydro-2-methyl-4-oxoquinazolin-6-ylmethyl)-N- methylamino]-2-thenoyl)-L-glutamic acid (ZD1694; Tomudex) is a potent inhibitor of thymidylate synthase and causes cell death through disruption of DNA synthesis and repair by blocking the obligatory thymidine nucleotide synthesis....

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章

    doi:10.3109/10428199809058358

    authors: Ek O,Reaman GH,Crankshaw DL,Chelstrom LM,Myers DE,Uckun FM

    更新日期:1998-02-01 00:00:00

  • Serum soluble interleukin-2 receptor levels in hairy cell leukemia: correlation with clinical and hematological parameters and with alpha-interferon treatment.

    abstract::The soluble Interleukin-2 Receptor (sIL-2R) serum levels were assessed in 42 patients with Hairy-Cell Leukemia (HCL) at diagnosis and after alpha-Interferon therapy and correlated with spleen size, peripheral hematological values, hairy cell index (HCI) and clinical response. Serum sIL-2R levels were significantly inc...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章

    doi:10.3109/10428199209053608

    authors: Lauria F,Rondelli D,Raspadori D,Zinzani PL,Benfenati D,Pileri S,Sabattini E,Tura S

    更新日期:1992-05-01 00:00:00

  • Mitoxantrone-DHAP with GM-CSF: an active but myelosuppressive salvage therapy for relapsed/refractory aggressive non-Hodgkin's lymphoma.

    abstract::This study was designed to evaluate the efficacy and toxicity of dose intensifying DHAP (dexamethasone, cytarabine and cisplatin) salvage chemotherapy by adding mitoxantrone with GM-GSF support in patients with relapsed or refractory non-Hodgkin's lymphoma (NHL). From March 1992 to January 1995, 22 patients with inter...

    journal_title:Leukemia & lymphoma

    pub_type: 临床试验,杂志文章

    doi:10.1080/10428199909169617

    authors: Haq R,Sawka CA,Franssen E,Berinstein NL

    更新日期:1999-11-01 00:00:00

  • Association of provider experience and clinical outcomes in patients with myelodysplastic syndromes receiving hypomethylating agents.

    abstract::Population level survival of patients with myelodysplastic syndromes (MDS) treated with hypomethylating agents (HMA) is inferior to clinical trials. Using SEER-Medicare data, we identified 2086 MDS patients diagnosed in 2004-13, aged ≥66 years at diagnosis, and receiving ≥1 HMA cycle after 2005. We used multivariate l...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章

    doi:10.1080/10428194.2019.1663423

    authors: Zeidan AM,Hu X,Zhu W,Stahl M,Wang R,Huntington SF,Giri S,Bewersdorf JP,Podoltsev NA,Gore SD,Ma X,Davidoff AJ

    更新日期:2020-02-01 00:00:00

  • An autopsy case of aggressive CD30+ extra-nodal NK/T-cell lymphoma initially manifested with granulomatous myositis.

    abstract::This study reports an autopsy case of a 53 year-old male with rapidly progressive extra-nodal NK/T-cell lymphoma accompanied with unusual clinical and pathologic features. He was initially presented with localized swelling and tenderness in the right lower extremity and the biopsy from the calf muscle was interpreted ...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章

    doi:10.1080/10428190500288545

    authors: Min HS,Hyun CL,Paik JH,Jeon YK,Choi G,Park SH,Seo JW,Kim CW

    更新日期:2006-02-01 00:00:00

  • Treatment of Waldenstrom's macroglobulinemia with nucleoside analogues.

    abstract::Sixty-eight patients with Waldenstrom's macroglobulinemia were treated either with fludarabine (28 patients) or 2-chlorodeoxyadenosine (40 patients) and responding patients were followed without further treatment. Both programs were well tolerated and myelosuppression was moderate but reversible. Overall, 35 patients ...

    journal_title:Leukemia & lymphoma

    pub_type: 临床试验,杂志文章

    doi:10.3109/10428199309064269

    authors: Dimopoulos MA,O'Brien S,Kantarjian H,Estey EE,Keating MJ,Alexanian R

    更新日期:1993-01-01 00:00:00

  • Acute promyelocytic leukemia, hypogranular variant, with uncharacteristic staining with chloroacetate esterase.

    abstract::A diagnosis of the hypogranular variant of acute promyelocytic leukemia (APLv) may be difficult to establish based on cytomorphology alone. However, the great majority of cases have a classical immunophenotype by flow cytometric immunophenotyping (FCI) (CD13+, CD33+, dim CD64+, HLA-DR-, and CD34-) and a classical enzy...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章

    doi:10.3109/10428190109097693

    authors: Dunphy CH,Polski JM,Johns G,Evans HL,Gardner LJ

    更新日期:2001-06-01 00:00:00

  • Imaging of lymphoma manifestations in the extracranial head and neck region.

    abstract::CT and MRI are the most efficient imaging techniques for diagnosing lymphomas while Gallium-67 scintigraphy is used to assess treatment results. In this review, the imaging aspects of lymphoma are addressed according to anatomical subregions, from the orbit to the trachea, Waldeyer's ring being the most common site, i...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章,评审

    doi:10.3109/10428199409059588

    authors: Chisin R,Weber AL

    更新日期:1994-01-01 00:00:00

  • Acute myeloid leukemia risk by industry and occupation.

    abstract::Acute myeloid leukemia (AML) is the most common type of leukemia found in adults. Identifying jobs that pose a risk for AML may be useful for identifying new risk factors. A matched case-control analysis was conducted using California Cancer Registry data from 1988 to 2007. This study included 8999 cases of AML and 24...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章

    doi:10.3109/10428194.2014.894189

    authors: Tsai RJ,Luckhaupt SE,Schumacher P,Cress RD,Deapen DM,Calvert GM

    更新日期:2014-11-01 00:00:00

  • Unusual chromosome abnormalities in primary central nervous system lymphoma.

    abstract::Primary central nervous system (PCNS) lymphoma is a relatively rare disease. The Epstein-Barr virus (EBV) has often been implicated in the development of lymphomas. Few cytogenetic. studies on PCNS lymphomas have been reported. We describe here an unusual case of PCNS B cell lymphoma, centroblastic polymorphic type wi...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章

    doi:10.3109/10428199609093453

    authors: Zattara-Cannoni H,Horshowski N,Figarella-Branger D,Dufour H,Grisoli F,Vagner-Capodano AM

    更新日期:1996-05-01 00:00:00

  • A novel therapeutic strategy against monocytic leukemia with deoxyadenosine analogs and adenosine deaminase inhibitors.

    abstract::The adenosine deaminase inhibitor 2'-deoxycoformycin (dCF) significantly inhibits the proliferation of leukemia and lymphoma cells in the presence of either 2'-deoxyadenosine (dAdo) or its analog adenine arabinoside (araA). The concentration of dCF required to induce apoptosis of monocytoid leukemia cells is much lowe...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章,评审

    doi:10.3109/10428190109097714

    authors: Honma Y

    更新日期:2001-09-01 00:00:00

  • Microsatellite instability indicative of defects in the major mismatch repair genes is rare in patients with B-cell chronic lymphocytic leukemia: Evaluation with disease stage and family history.

    abstract::A possible role for DNA mismatch repair defects and microsatellite instability (MSI) in the pathogenesis of a number of B-cell lymphoproliferative disorders has recently been debated. To gain further insight into the impact of MSI on B-CLL, we evaluated samples from a series of 982 patients using the mono-satellite ma...

    journal_title:Leukemia & lymphoma

    pub_type: 杂志文章

    doi:10.1080/10428190701361844

    authors: Sellick GS,Lubbe SJ,Matutes E,Catovsky D,Houlston RS

    更新日期:2007-07-01 00:00:00