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.
Eur J Haematol. 2022 Jul;109(1):58-68. doi: 10.1111/ejh.13769. Epub 2022 Apr 13.
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).
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.
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).
Patients with AML ineligible for intensive therapy have high HRU; novel therapies are needed to alleviate this burden.
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。
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。
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%）。
不适合强化治疗的 AML 患者 HRU 较高，需要新的疗法来减轻这一负担。
