Incidence, Cost, and Outcomes of Bleeding and Chemotherapy Dose Modification Among Solid Tumor Patients With Chemotherapy-Induced Thrombocytopenia

Elting, Linda S.; Rubenstein, Edward; Martin, Charles G.; Kurtin, Danna; Rodriguez, Saul; Laiho, Esa; Kanesan, Krishnakumari; Cantor, Scott B.; Benjamin, Robert S.

doi:10.1200/jco.2001.19.4.1137

Cited by 157 publications

(128 citation statements)

References 18 publications

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“…[1][2][3] Clinically significant bleeding due to thrombocytopenia is relatively uncommon, occurring in fewer than 10% of chemotherapy cycles that are complicated by thrombocyto-penia. However, fatal bleeding does occur infrequently.…”

mentioning

confidence: 99%

Pharmacoeconomic analysis of oprelvekin (recombinant human interleukin‐11) for secondary prophylaxis of thrombocytopenia in solid tumor patients receiving chemotherapy

Cantor

Elting

Hudson

et al. 2003

Cancer

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BACKGROUNDPrevious research has shown oprelvekin (recombinant human interleukin‐11 [rhIL‐11]) to be effective in reducing the requirements for platelet transfusions after myelosuppressive chemotherapy in patients who have previously experienced thrombocytopenia. The economic consequences of the routine use of this platelet growth factor and the usual standard of platelet transfusions for prophylaxis of severe chemotherapy‐induced thrombocytopenia have not been compared.METHODSThe authors constructed a decision‐analytic model to compare the alternatives of rhIL‐11 versus usual care using probability, outcome, and cost data from previously published clinical trials and their own institutional sources. They incorporated the costs of platelet transfusions and adverse events from rhIL‐11 into the analysis. Quality‐of‐life outcomes were not considered. The pharmacoeconomic analysis was based on the criterion of cost minimization from the payer's perspective.RESULTSThe expected cost of the usual care strategy for prophylaxis of severe thrombocytopenia (transfusion when platelets < 20,000 μL−1) was $3495 for a 3‐week cycle of chemotherapy. The prophylactic rhIL‐11 strategy was more expensive, with an expected cost of $5328 over the same time period. Nonetheless, it was associated with fewer platelet transfusions, avoiding an average of 6.7 U compared with usual care. The savings from avoidance of platelet transfusion and adverse reactions to transfusion from the use of rhIL‐11 were not offset by the substantial cost of the pharmaceutical. The greater expected costs from the rhIL‐11 strategy were relatively insensitive to the unit price and efficacy of rhIL‐11 and the costs of platelet transfusions and monitoring.CONCLUSIONSFrom the payer's perspective, rhIL‐11 cannot be considered a cost‐saving clinical strategy compared with routine platelet transfusions for patients with severe chemotherapy‐induced thrombocytopenia. Cancer 2003;97:3099–106. © 2003 American Cancer Society.DOI 10.1002/cncr.11447

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confidence: 99%

Pharmacoeconomic analysis of oprelvekin (recombinant human interleukin‐11) for secondary prophylaxis of thrombocytopenia in solid tumor patients receiving chemotherapy

Cantor

Elting

Hudson

et al. 2003

Cancer

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“…The incidence of thrombocytopenia among solid cancer patients is rather low i.e., ranging between 10%-25% among breast cancer, ovarian and germ cell cancer patients who were treated with intensive chemotherapy. However thrombocytopenia incidence is high among acute leukemia patients [56][57][58][59][60][61][62][63].…”

Section: Thrombocytopeniamentioning

confidence: 99%

“…While in case of solid tumor, thrombocytopenia happens because of chemotherapy uses and thus the incidence is rather low. However in some subgroups the incidence is higher than 20% and it still remain as a serious and dangerous problem [62].…”

Section: Stabilization Of the Clot (Step 4)mentioning

confidence: 99%

Supportive and Palliative Care in Solid Cancer Patients

Hassan¹,

Yusoff²,

Othman³

2013

Cancer Treatment - Conventional and Innovative Approaches

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“…Several guidelines recommend dose reduction in case of CIT, although full dose, on time chemotherapy could lead to reduced tumor burden and better overall survival (1a-3a). Thus, patients with CIT will experience potentially life threatening complications, delay in treatment, poorer outcomes and increases of health care resources (Elting et al, 2001). At present, platelet transfusions remain the "gold-standard" for the management of severe CIT, but there are many issues and possible complications associated with platelet transfusions (Clarke et al, 1996).…”

Section: Introductionmentioning

confidence: 99%

A Clinical Study on Juheli (Recombinant Human Interleukin - 11) in the Second Prevention of Chemotherapy Induced Thrombocytopenia

Xiao

Liu²,

Huang³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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Objective: to investigate the effect and side effects of recombinant human interleukin -11 (rhIL -11, in Chinese Juheli, produced by Qi Lu Biotechnology CO., LTD) in the second prevention of chemotherapy induced thrombocytopenia (CIT). Methods: Cancer patients with CIT were recruited and were treated with rhIL -11 (treatment phase, TP), and in the following cycle, all these patients administered with rhIL -11 24 hours immediately after chemotherapy (preventive treatment phase, PTP). Duration and severity of thrombocytopenia between two phases were compared. Results: for patients in TP or PTP, nadir values of platelet were (29.28±20.08)×10 9 /L and (45.24±19.66)×10 9 /L, duration of thrombocytopenia in TP and PTP was (11.52±4.33) and (8.20±+2.77)days, recovery time was (19.40±3.89)and (13.44±3.02)days, duration of rhIL -11 administration was 10.68±2.46)and (6.28±1.77)days, number of patients needing platelet infusion was 16and4 respectively, all differences were statistically significant (p value were 0.007, 0.002, 0.000, 0.000, 0.034 respectively). For TP and PTP, number of patients with hemorrhage was 8 and 4, duration of bleeding was (5.00±0.82) and (4.50 ± 0.71) days respectively, with no statistically significant difference. Adverse reactions mainly included fever, edema, arrhythmia, joint pain, fatigue, skin rash, headache, dizziness, etc., all were not statistically significant between TP and PTP. Conclusion: rhIL -11 could be well tolerated and is effective that could reduce the duration, severity of CIT, platelet transfusion, and incidence of bleeding, as well as shorten the recovery time, duration of rhIL -11 administration. Thus, rhIL -11 could be commended in the second prevention of CIT for patients with cancer.

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Incidence, Cost, and Outcomes of Bleeding and Chemotherapy Dose Modification Among Solid Tumor Patients With Chemotherapy-Induced Thrombocytopenia

Cited by 157 publications

References 18 publications

Pharmacoeconomic analysis of oprelvekin (recombinant human interleukin‐11) for secondary prophylaxis of thrombocytopenia in solid tumor patients receiving chemotherapy

Pharmacoeconomic analysis of oprelvekin (recombinant human interleukin‐11) for secondary prophylaxis of thrombocytopenia in solid tumor patients receiving chemotherapy

Supportive and Palliative Care in Solid Cancer Patients

A Clinical Study on Juheli (Recombinant Human Interleukin - 11) in the Second Prevention of Chemotherapy Induced Thrombocytopenia

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