不适合强化化疗的急性髓细胞白血病患者一线系统治疗或最佳支持治疗的医疗资源利用趋势：一项多中心国际研究。

Healthcare resource utilization trends in patients with acute myeloid leukemia ineligible for intensive chemotherapy receiving first-line systemic treatment or best supportive care: A multicenter international study.

机构信息

First Department of Internal Medicine, Kansai Medical University, Hirakata, Osaka, Japan.

Leukemia/Bone Marrow Transplant Program of BC, Division of Hematology, University of British Columbia, Vancouver, British Columbia, Canada.

出版信息

Eur J Haematol. 2022 Jul;109(1):58-68. doi: 10.1111/ejh.13769. Epub 2022 Apr 13.

DOI:10.1111/ejh.13769

PMID:35298049

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9324937/

Abstract

OBJECTIVES

This retrospective chart review examined real-world healthcare resource utilization (HRU) in patients with AML ineligible for intensive therapy who received first-line systemic therapy or best supportive care (BSC).

METHODS

Data were collected anonymously on patients with AML who initiated first-line hypomethylating agents (HMA), low-dose cytarabine (LDAC), other systemic therapy, or BSC. HRU endpoints included hospitalizations, outpatient consultations, transfusions, and supportive care.

RESULTS

Of 1762 patients included, 46% received HMA, 11% received LDAC, 17% received other systemic therapy, 26% received BSC; median treatment durations were 118, 35, 33, and 57 days, respectively. Most patients were hospitalized, most commonly for treatment administration, transfusion, or infection (HMA 82%, LDAC 93%, other systemic therapy 83%, BSC 83%). A median number of hospitalizations were 2-6 across systemic groups and two for BSC, with median durations of 8-18 days. Transfusion rates and outpatient consultations were highest for HMA (80% and 79%) versus LDAC (57% and 53%), other systemic therapy (57% and 63%), and BSC (71% and 66%). Antivirals/antibiotics and antifungals were used more frequently than growth factors (72-92%, 34-63%, and 7-27%, respectively).

CONCLUSION

Patients with AML ineligible for intensive therapy have high HRU; novel therapies are needed to alleviate this burden.

摘要

目的

本回顾性图表研究调查了不适合强化治疗的 AML 患者接受一线系统治疗或最佳支持治疗（BSC）的真实世界医疗资源利用（HRU）情况。

方法

匿名收集了接受一线低甲基化剂（HMA）、低剂量阿糖胞苷（LDAC）、其他系统治疗或 BSC 的 AML 患者的资料。HRU 终点包括住院、门诊咨询、输血和支持性护理。

结果

在纳入的 1762 名患者中，46%接受 HMA，11%接受 LDAC，17%接受其他系统治疗，26%接受 BSC；中位治疗持续时间分别为 118、35、33 和 57 天。大多数患者住院，最常见的是治疗管理、输血或感染（HMA 82%、LDAC 93%、其他系统治疗 83%、BSC 83%）。大多数系统治疗组的中位住院次数为 2-6 次，BSC 组为 2 次，中位住院时间为 8-18 天。HMA 的输血率和门诊咨询率最高（80%和 79%），其次是 LDAC（57%和 53%）、其他系统治疗（57%和 63%）和 BSC（71%和 66%）。抗病毒/抗生素和抗真菌药物的使用率高于生长因子（72%-92%、34%-63%和 7%-27%）。