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估算加拿大安大略省≥65 岁新诊断的套细胞淋巴瘤(MCL)患者的疾病负担和医疗保健利用情况。

Estimating the Associated Burden of Illness and Healthcare Utilization of Newly Diagnosed Patients Aged ≥65 with Mantle Cell Lymphoma (MCL) in Ontario, Canada.

机构信息

Stronach Regional Cancer Centre, Southlake Regional Health Centre, Newmarket, ON L3Y 2P9, Canada.

Bayshore HealthCare, 2101 Hadwen Rd., Mississauga, ON L5K 2L3, Canada.

出版信息

Curr Oncol. 2023 Jun 8;30(6):5529-5545. doi: 10.3390/curroncol30060418.

Abstract

BACKGROUND

With the emergence of therapies for mantle cell lymphoma (MCL), understanding the treatment patterns and burden of illness among older patients with MCL in Canada is essential to inform decision making.

METHODS

A retrospective study using administrative data matched individuals aged ≥65 who were newly diagnosed with MCL between 1 January 2013 and 31 December 2016 with general population controls. Cases were followed for up to 3 years in order to assess healthcare resource utilization (HCRU), healthcare costs, time to next treatment or death (TTNTD), and overall survival (OS); all were stratified according to first-line treatment.

RESULTS

This study matched 159 MCL patients to 636 controls. Direct healthcare costs were highest among MCL patients in the first year following diagnosis (Y1: CAD 77,555 ± 40,789), decreased subsequently (Y2: CAD 40,093 ± 28,720; Y3: CAD 36,059 ± 36,303), and were consistently higher than the costs for controls. The 3-year OS after MCL diagnosis was 68.6%, with patients receiving bendamustine + rituximab (BR) experiencing a significantly higher OS compared to patients treated with other regimens (72.4% vs. 55.6%, = 0.041). Approximately 40.9% of MCL patients initiated a second-line therapy or died within 3 years.

CONCLUSION

Newly diagnosed MCL presents a substantial burden to the healthcare system, with almost half of all patients progressing to a second-line therapy or death within 3 years.

摘要

背景

随着套细胞淋巴瘤(MCL)治疗方法的出现,了解加拿大老年 MCL 患者的治疗模式和疾病负担对于决策至关重要。

方法

本研究使用行政数据进行回顾性研究,匹配了 2013 年 1 月 1 日至 2016 年 12 月 31 日期间新诊断为 MCL 的年龄≥65 岁的个体与一般人群对照。对病例进行了长达 3 年的随访,以评估医疗资源利用(HCRU)、医疗费用、下一次治疗或死亡的时间(TTNTD)和总生存(OS);所有患者均根据一线治疗进行分层。

结果

本研究将 159 例 MCL 患者与 636 例对照相匹配。在诊断后的第一年(Y1:CAD77555±40789),MCL 患者的直接医疗费用最高,随后逐年下降(Y2:CAD40093±28720;Y3:CAD36059±36303),且始终高于对照组的费用。MCL 诊断后 3 年的 OS 为 68.6%,接受苯达莫司汀+利妥昔单抗(BR)治疗的患者 OS 显著高于接受其他方案治疗的患者(72.4%比 55.6%,P=0.041)。约 40.9%的 MCL 患者在 3 年内开始二线治疗或死亡。

结论

新诊断的 MCL 给医疗系统带来了巨大负担,近一半的患者在 3 年内进展到二线治疗或死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/254c/10297405/87655df1e14b/curroncol-30-00418-g001.jpg

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