Department of Health Economics, RTI Health Solutions, Research Triangle Park, NC, USA.
Department of Lymphoma and Myeloma, MD Anderson Cancer Center, Houston, TX, USA.
Leuk Lymphoma. 2021 Jun;62(6):1325-1334. doi: 10.1080/10428194.2021.1919662. Epub 2021 May 8.
Most data on overall survival (OS) and adverse events (AEs) in patients with mantle cell lymphoma (MCL) are from controlled trials; therefore, in this population-based study, we retrospectively assessed treatment patterns, OS, and AEs in MCL patients initiating systemic treatment during 2013-2015 using the United States Medicare claims database. Among 1390 eligible patients (median age = 74 years), chemoimmunotherapy with bendamustine/rituximab (BR) was the preferred choice in first-line (35.3%), followed by ibrutinib (33.5%), rituximab (9.1%), and rituximab/cyclophosphamide/doxorubicin/vincristine (R-CHOP) (6.8%). Twenty-four-month OS was 73% for BR; 47%, ibrutinib; 72%, rituximab; and 71%, R-CHOP. For the four most commonly used regimens, neutropenia, anemia, hypertension, and infection were the most frequent AEs. Patients with ≥3 AEs had nearly four times higher monthly costs than those with 0-2 AEs in the first observed therapy line. Findings demonstrate a substantial increase in the economic burden as the number of AEs increased among the Medicare MCL patients.
大多数关于套细胞淋巴瘤（MCL）患者总生存期（OS）和不良事件（AEs）的数据来自对照试验；因此，在这项基于人群的研究中，我们使用美国医疗保险索赔数据库，回顾性评估了 2013-2015 年期间接受系统治疗的 MCL 患者的治疗模式、OS 和 AEs。在 1390 名符合条件的患者中（中位年龄=74 岁），在一线治疗中，苯达莫司汀/利妥昔单抗（BR）联合化疗（35.3%）是首选，其次是伊布替尼（33.5%）、利妥昔单抗（9.1%）和利妥昔单抗/环磷酰胺/多柔比星/长春新碱（R-CHOP）（6.8%）。BR 的 24 个月 OS 为 73%；伊布替尼为 47%，利妥昔单抗为 72%，R-CHOP 为 71%。对于四种最常用的方案，中性粒细胞减少症、贫血、高血压和感染是最常见的 AE。在第一个观察到的治疗线中，发生≥3 种 AE 的患者每月费用几乎是发生 0-2 种 AE 的患者的四倍。这些发现表明，随着 Medicare MCL 患者的 AE 数量增加，其经济负担显著增加。
