Predicting mortality and cost of hematopoeitic stem-cell transplantation

Kerbauy, Fábio R.; Morelli, Leonardo Raul; Andrade, Cláudia Toledo de; Lisboa, Luis Fernando; Neto, Miguel Cendoroglo; Hamerschlak, Nelson

doi:10.1590/s1679-45082012000100017

Cited by 7 publications

(6 citation statements)

References 11 publications

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“…The overall expenses may vary according to the donor type (higher for unrelated donors than for sibling donors) [12][13][14], the source of stem cells (higher for cord blood than for bone marrow or peripheral blood) [14], and intensity of the conditioning regimen [14,15]. The costs may also depend on the patient selection, being increased for individuals with high risk for treatment failure [16]. Marked differences between costs of alloHCT from sibling donors have been reported between countries (e.g., $148,709 [initial hospitalization] in the U.S. compared with $17,914 in India) [17,18].…”

Section: Discussionmentioning

confidence: 99%

Association of Macroeconomic Factors With Nonrelapse Mortality After Allogeneic Hematopoietic Cell Transplantation for Adults With Acute Lymphoblastic Leukemia: An Analysis From the Acute Leukemia Working Party of the EBMT

et al. 2016

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Acute lymphoblastic leukemia x Non-relapse mortality ABSTRACT Purpose. From a global perspective, the rates of allogeneic hematopoietic cell transplantation (alloHCT) are closely related to the economic status of a country. However, a potential association withoutcome hasnot yet been documented.The goal ofthis study was to evaluate effects of health care expenditure (HCE), Human Development Index (HDI),team density, and center experience on nonrelapsemortality(NRM)afterHLA-matchedsiblingalloHCTfor adults with acute lymphoblastic leukemia (ALL). Patients and Methods. A total of 983 patients treated with myeloablative alloHCT between 2004 and 2008 in 24 European countries were included. Results. In a univariate analysis, the probability of day 100 NRM was increased for countries with lower current HCE (8% vs. 3%; p 5 .06), countries with lower HDI (8% vs. 3%; p 5 .02), and centers with less experience (8% vs. 5%; p 5 .04). In addition, the overall NRM was increased for countries with lower current HCE (21% vs. 17%; p 5 .09) and HDI (21% vs. 16%; p 5 .03) and for centers with loweractivity (21% vs. 16%;p 5 .07). In a multivariate analysis,the strongest predictive model for day 100 NRM included current HCE greater than the median (hazard ratio [HR], 0.39; p 5 .002).The overall NRM was mostly predicted by HDI greater than the median (HR, 0.65; p 5 .01). Both lower current HCE and HDI were associated with decreased probability of overall survival. Conclusion. Both macroeconomic factors and the socioeconomic status of a country strongly influence NRM after alloHCT for adults with ALL. Our findings should be considered when clinical studies in the field of alloHCT are interpreted. The Oncologist 2016;21:377-383 Implications for Practice: Results of allogeneic hematopoietic cell transplantation (alloHCT) and other advanced oncological procedures may vary among countries and be related to various economic factors.This study, which included a homogenous population of patients with acute lymphoblastic leukemia, demonstrated significant associations of health care expenditure and the Human Development Index with nonrelapse mortality and overall survival after transplantation.The findings should be taken into account when clinical studies in the field of alloHCT are interpreted. The study should be followed by further investigation in other fields of oncology.

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Section: Discussionmentioning

confidence: 99%

Association of Macroeconomic Factors With Nonrelapse Mortality After Allogeneic Hematopoietic Cell Transplantation for Adults With Acute Lymphoblastic Leukemia: An Analysis From the Acute Leukemia Working Party of the EBMT

et al. 2016

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“…Cost of transplant also varies with the type of transplant (autologous, allogeneic), source of graft (sibling or matched unrelated), intensity of conditioning regimens used etc 4,10–12. No correlation has been found in the cost of transplant and patient’s age and sex, disease risk, or status 5,9.…”

Section: Discussionmentioning

confidence: 99%

Cost of Hematopoietic Stem Cell Transplantation in India

Sharma

Choudhary

Gupta

et al. 2014

Mediterr J Hematol Infect Dis

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Hematopoietic stem cell transplantation (HSCT) is a definite cure for many hematological diseases. With the increasing indications for HSCT and its relatively low cost in Indian subcontinent, an increasing number of patients are opting for this procedure. We retrospectively analyzed the cost of one hundred sixty two HSCTs done at our center in the last three years. The median cost of autologous transplant was USD, $ 12,500 (range $ 10,331–39,367) and the median cost of allogeneic transplant was $ 17,914 (range $ 10,832–44,701). The cost of HSCT is cheaper here compared to that in developed countries and success rates are nearly equivalent. The major factors contributing to the cost are related to the complications post-transplant mainly infections and graft versus host disease, which are also the reasons for the increased stay in the hospital.

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“…Based on a similar study (20), the volume of the sample in each group was estimated as 14 patients and 14 family members using Pupak formulation and with confidence level of 95% and test power of 95%. However, volume of sample increased to 23 patients and 23 caregivers in each group in order to consider possibility of sample loss, increase accuracy of the study and use Fabio Rodrigues Kerbauy' study (21). Sampling was conducted through the available method during fall 2014.…”

Section: Methodsmentioning

confidence: 99%

The Effect of Family-Centered Empowerment Model on the Quality of Life of Patients with Leukemia

Davarpanah

Fayazi

Shariati

et al. 2016

Jundishapur J Chronic Dis Care

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Background: Leukemia is a common cancer among adults with growing prevalence in Iran. This disease affects different aspects of the patient, especially their quality of life. One of the methods to promote hygiene and health and, consequently, quality of life is to empower the family of the patient. Objectives: The effect of family-based empowerment on quality of life in patients with leukemia was studied in this research. Methods: This study was a clinical trial conducted on 46 adult patients with leukemia together with 46 of their family members in 2015. Eligible patients were selected by the available method and randomly placed in two groups of test and control. Tools for gathering data included a demographic questionnaire about the patient and their family member and a specified questionnaire about the quality of life of patients with cancer. Family-based empowerment intervention was held for research samples in the test group based on its quadruple steps (perceived threat, self-efficiency promotion, increase of self-esteem through educational participation, and assessment) in six 90-minute sessions and a second test was conducted a month and half after the intervention. Data were analyzed using the SPSS 20 statistical software. Results: Results of chi-square test reflected that both groups of test and control were similar in terms of demographic information (P > 0.5). Moreover, statistical independent T-test did not show a significant difference in aspects of quality of life in test and control groups before the intervention (P = 0.98) while this test showed a significant difference in both groups after the intervention (P = 0.00), except for the spiritual aspect (p=0.2). Paired T-test indicated a significant increase in aspects of quality of life in the test group after the intervention (p=0.00) while this test reflected a reverse significant difference in general aspect of quality of life in the control group (P = 0.006). Conclusions:In general, results of this research showed that implementing family-based empowerment pattern has been effective for increasing quality of life in patients with leukemia.

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Predicting mortality and cost of hematopoeitic stem-cell transplantation

Abstract: The validation of the Pretransplantion Assesment of Mortality risk score in our patients confirmed that this system is an important tool to be used in transplantation units, being easy to apply and fully reproducible.

Cited by 7 publications

References 11 publications

Association of Macroeconomic Factors With Nonrelapse Mortality After Allogeneic Hematopoietic Cell Transplantation for Adults With Acute Lymphoblastic Leukemia: An Analysis From the Acute Leukemia Working Party of the EBMT

Association of Macroeconomic Factors With Nonrelapse Mortality After Allogeneic Hematopoietic Cell Transplantation for Adults With Acute Lymphoblastic Leukemia: An Analysis From the Acute Leukemia Working Party of the EBMT

Cost of Hematopoietic Stem Cell Transplantation in India

The Effect of Family-Centered Empowerment Model on the Quality of Life of Patients with Leukemia

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