R-CHOP与剂量调整R-EPOCH治疗高风险弥漫性大b细胞淋巴瘤的成本分析

Clinical Hematology International Pub Date : 2020-04-23 eCollection Date: 2020-09-01 DOI:10.2991/chi.d.200410.001
Bhagirathbhai Dholaria, Yenny Alejandra Moreno Vanegas, Nancy Diehl, Aaron C Spaulding, Sue Visscher, Han W Tun, Sikander Ailawadhi, Prakash Vishnu
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引用次数: 4

摘要

剂量调整的利妥昔单抗、依托泊苷、强的松、长春新碱、环磷酰胺和阿霉素(DA.R-EPOCH)用于高危弥漫性大B细胞淋巴瘤(DLBCL)的前期治疗。在这项研究中,我们比较了一线接受利妥昔单抗、环磷酰胺、阿霉素、长春新碱、泼尼松(R-CHOP)或DA治疗的高危DLBCL患者的结局。R-EPOCH immunochemotherapy。分析结果和治疗相关费用。具有以下特征之一的DLBCL纳入研究:FISH检测MYC±BCL2或BCL6重排或免疫组织化学检测MYC过表达,Ki67指数≥80%或非末端中心免疫表型,肿瘤测量≥5 cm, NCCN- IPI评分≥4。共有80例患者接受R-CHOP (n = 52, 65%)或DA治疗。R-EPOCH (n = 28,35%),中位随访11.2个月(范围0.7-151.3个月)。DA的无进展生存期和总生存期的风险比(hr)分别为0.79[95%可信区间(CI) 0.28% ~ 2.29%, p = 0.67]和0.86 (95% CI 0.26% ~ 2.78%, p = 0.80)。R-EPOCH和R-CHOP比较。DA的总平均成本分别为106,940±39,351美元和58,509±24,588美元。R-EPOCH和R-CHOP差异有统计学意义(p < 0.001)。在我们的分析中,在高风险DLBCL中,与R-CHOP相比,R-EPOCH的临床结果相当,治疗相关费用增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Cost Analysis of R-CHOP <i>Versus</i> Dose-Adjusted R-EPOCH in Treatment of Diffuse Large B-Cell Lymphoma with High-Risk Features.

Cost Analysis of R-CHOP Versus Dose-Adjusted R-EPOCH in Treatment of Diffuse Large B-Cell Lymphoma with High-Risk Features.

Dose-adjusted rituximab, etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA.R-EPOCH) is used for upfront treatment of high-risk diffuse large B cell lymphoma (DLBCL). In this study, we compared the outcomes in patients with high-risk DLBCL who received frontline rituximab, cycophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) or DA.R-EPOCH immunochemotherapy. Outcomes and treatment-related cost were analyzed. DLBCL with one of the following features were included in the study: MYC ± BCL2 or BCL6 rearrangement by FISH or MYC overexpression by immunohistochemistry, Ki67 index ≥ 80% or nongerminal center immunophenotype, tumor measuring ≥5 cm and NCCN- IPI score ≥4. A total of 80 patients were treated with R-CHOP (n = 52, 65%) or DA.R-EPOCH (n = 28, 35%), with a median follow-up of 11.2 months (range: 0.7-151.3 months). The hazard ratios (HRs) for progression-free survival and overall survival were 0.79 [95% confidence interval (CI) 0.28%-2.29%, p = 0.67] and 0.86 (95% CI 0.26%-2.78%, p = 0.80), respectively for DA.R-EPOCH compared to R-CHOP. The total mean cost was USD106,940 ± USD39,351 and USD58,509 ± 24,588 for DA.R-EPOCH and R-CHOP respectively (p < 0.001). In our analysis, DA.R-EPOCH resulted comparable clinical outcomes and increased treatment-related expenses compared to R-CHOP in high-risk DLBCL.

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