Palandri Francesca, Inzoli Alessandro, Barone Antonella, Dordoni Daniela, Formenti Elisa, Corradini D'Elia Giorgio, Rabsiun Aramburu Victoria Lucia, Palumbo Giuseppe Alberto, Breccia Massimo
Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy.
Hematology Unit, Ospedale Maggiore Azienda Socio Sanitaria Territoriale, Crema, Italy.
Front Oncol. 2025 Mar 7;15:1549023. doi: 10.3389/fonc.2025.1549023. eCollection 2025.
Anemia management in myelofibrosis (MF) remains a major challenge, often resulting in blood transfusions as the condition progresses. The BEAT project aimed to quantify the economic and organizational burden of anemia and transfusions in MF patients in Italy from the patient and hospital perspectives.
Data were collected from two primary sources: (i) semi-structured interviews with 13 hematologists and 1 transfusionist from 13 Italian MF reference centers; (ii) an online questionnaire completed by 191 patients distributed by AIPAMM (Italian Association of Patients with Myeloproliferative Diseases). Patients were categorized into 9 patient types based on the Dynamic International Prognostic Scoring System (DIPSS), anemia status, and need for transfusions. The collected data was used to feed an analytical model to quantify time and costs for patients, caregivers and the healthcare system over one year for managing MF, MF-related anemia, and transfusion care for each patient type.
Transfusion dependent patients spend, on average, six times more time on MF care compared to non-anemic patients (133.1 vs 20.9 hours/year). Transfusion-related hospital visits represent a major burden, with waiting times accounting for 44% of total access time (about 7.3 hours). Annual hospital management time and estimated costs per patient are 17.0 vs. 5.2 vs. 3.5 hours/year, and €6,603 vs. €249 vs. €165/year for transfusion dependent, anemic non-transfusion dependent, and non-anemic patients, respectively. Indirect social costs for transfusion dependent patients (€2,332) are estimated to be six times greater than those for non-anemic patients (€367). Patient surveys confirmed the significant impact of transfusion dependency on work, social, and daily life, with scores of 4.5/5 for work and over 4/5 for social and daily life.
These findings highlight the urgent need for optimizing MF-related anemia and transfusion management to help mitigate the economic strain on healthcare systems and lessen the time-related and emotional impact on patients and caregivers.
骨髓纤维化（MF）的贫血管理仍然是一项重大挑战，随着病情进展，常常导致输血治疗。BEAT项目旨在从患者和医院的角度量化意大利MF患者贫血和输血的经济及组织负担。
数据收集自两个主要来源：（i）对来自13个意大利MF参考中心的13名血液科医生和1名输血科医生进行的半结构化访谈；（ii）由意大利骨髓增殖性疾病患者协会（AIPAMM）分发的191名患者填写的在线问卷。根据动态国际预后评分系统（DIPSS）、贫血状态和输血需求，将患者分为9种患者类型。收集到的数据用于输入一个分析模型，以量化每种患者类型在一年中患者、护理人员和医疗系统管理MF、MF相关贫血和输血护理的时间和成本。
与非贫血患者相比，依赖输血的患者在MF护理上平均花费的时间多六倍（133.1小时/年对20.9小时/年）。与输血相关的医院就诊是一项主要负担，等待时间占总就诊时间的44%（约7.3小时）。依赖输血、贫血但不依赖输血和非贫血患者的年度医院管理时间和估计成本分别为17.0小时/年对5.2小时/年对3.5小时/年，以及6603欧元/年对249欧元/年对165欧元/年。依赖输血患者的间接社会成本（2332欧元）估计是非贫血患者（367欧元）的六倍。患者调查证实了输血依赖对工作、社交和日常生活的重大影响，工作方面得分为4.5/5，社交和日常生活方面得分超过4/5。
这些发现凸显了优化MF相关贫血和输血管理的迫切需求，以帮助减轻医疗系统的经济压力，并减轻对患者和护理人员的时间相关及情感影响。
