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Titolo:
Cytarabine added to interferon improves the cost-effectiveness of initial therapy for patients with early chronic phase chronic myelogenous leukemia
Autore:
Beck, JR; Guilhot, J; Giles, FJ; Aoki, N; Wirt, DP; Guilhot, F;
Indirizzi:
Baylor Coll Med, Informat Technol Program, Houston, TX 77030 USA Baylor Coll Med Houston TX USA 77030 chnol Program, Houston, TX 77030 USA
Titolo Testata:
LEUKEMIA & LYMPHOMA
fascicolo: 1-2, volume: 41, anno: 2001,
pagine: 117 - 124
SICI:
1042-8194(200103)41:1-2<117:CATIIT>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
CHRONIC MYELOID-LEUKEMIA; BONE-MARROW TRANSPLANTATION; LOW-DOSE CYTARABINE; CYTOSINE-ARABINOSIDE; ALPHA; CHEMOTHERAPY; HYDROXYUREA; BIOLOGY; BUSULFAN; DISEASE;
Keywords:
leukemia; chronic myeloid; cost-effectiveness analysis; decision making; interferon; cytarabine;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Beck, JR Baylor Coll Med, Informat Technol Program, Houston, TX 77030 USA Baylor Coll Med Houston TX USA 77030 gram, Houston, TX 77030 USA
Citazione:
J.R. Beck et al., "Cytarabine added to interferon improves the cost-effectiveness of initial therapy for patients with early chronic phase chronic myelogenous leukemia", LEUK LYMPH, 41(1-2), 2001, pp. 117-124

Abstract

The French Chronic Myeloid Leukemia Study Group prospective randomized study results indicate that the addition of cytarabine to alpha interferon (IFN-alpha) increases the rate of major cytogenetic response and prolongs survival in patients with early chronic phase chronic myelogenous leukemia (CML). The French group study design permitted a single crossover to include ordiscontinue cytarabine or interferon. Endpoints were overall survival, complete hematologic remission (CHR) at air months, and major cytogenetic response at 12 months. We modified a published Markov model that compared IFN-alpha alone to IFN-alpha plus cytarabine and included the possibility of crossover as in the French study. The model permits allogeneic and autologous stem cell transplantation (SCT), and follows cytogenetic response and acceleration of CML through death. Treatment response. toxicity, and survival are drawn from the French Chronic Myeloid Leukemia Study Group population of 810 patients on an intention-to-treat model. Survivals are extended to 62 months based on currently available follow-up. Costs from a United Slates oncology specialty institution, and state utilities: from previous research and a quality-adjusted Time Without Symptoms or Toxicity analysis of the subject study were discounted at 3% per annum. At the median cohort age of 50,cytarabine offers 21 months of added median survival to IFN-alpha, which itself is superior to conventional chemotherapy by 21 months. Cost-effectiveness estimates for cytarabine added to IFN-alpha range from $7.000 per quality-adjusted life year (QALY) to $35,000 per QALY, under all plausible assumptions superior to IFN-alpha alone. The model is: sensitive to the qualityof life on therapy, as well as to remission rate with additive cytarabine,although the cost-effectiveness calculations are robust over the entire range of clinical assumptions. Based on data from the French study, cytarabine added to IFN-alpha substantially improves the cost-effectiveness of initial therapy for early chronic phase CML.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/01/21 alle ore 12:25:33