The Impact of Donor Type on Outcomes and Cost of Allogeneic Hematopoietic Cell Transplantation for Pediatric Leukemia: A Merged Center for International Blood and Marrow Transplant Research and Pediatric Health Information System Analysis

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The Impact of Donor Type on Outcomes and Cost of Allogeneic Hematopoietic Cell Transplantation for Pediatric Leukemia : A Merged Center for International Blood and Marrow Transplant Research and Pediatric Health Information System Analysis

Arnold, Staci D. (författare): Emory Univ, Childrens Healthcare Atlanta, Aflac Canc & Blood Disorder Ctr, Atlanta, GA 30322 USA.

Brazauskas, Ruta (författare): Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Inst Hlth & Equ, Div Biostat, Milwaukee, WI 53226 USA.

He, Naya (författare): Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.

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Li, Yimei (författare): Univ Penn, Dept Biostat Epidemiol & Informat, Philadelphia, PA 19104 USA.

Hall, Matt (författare): Childrens Hosp Assoc, Mission, KS USA.

Atsuta, Yoshiko (författare): Japanese Data Ctr Hematopoiet Cell Transplantat, Nagoya, Aichi, Japan.;Nagoya Univ, Grad Sch Med, Dept Biostat Epidemiol & Informat, Nagoya, Aichi, Japan.

Dalal, Jignesh (författare): Rainbow Babies & Childrens Hosp, Dept Biostat Epidemiol & Informat, 2101 Adelbert Rd, Cleveland, OH 44106 USA.

Hahn, Theresa (författare): Roswell Pk Canc Inst, Dept Med, Buffalo, NY USA.

Khera, Nandita (författare): Mayo Clin, Dept Hematol Oncol, Phoenix, AZ USA.

Bonfim, Carmem (författare): Univ Fed Parana, Hosp Clin, Dept Biostat Epidemiol & Informat, Curitiba, Parana, Brazil.

Hashmi, Shahrukh (författare): King Faisal Specialist Hosp & Res Ctr, Oncol Ctr, Riydah, Saudi Arabia.;Mayo Clin, Dept Internal Med, Rochester, MN USA.

Parsons, Susan (författare): Tufts Med Ctr, Dept Biostat Epidemiol & Informat, Boston, MA 02111 USA.

Wood, William A. (författare): Univ N Carolina, Dept Med, Div Hematol & Oncol, Chapel Hill, NC 27515 USA.

Steinberg, Amir (författare): Mt Saini Hosp, Div Hematol & Oncol, New York, NY USA.

Freytes, Cesar O. (författare): Texas Transplant Inst, San Antonio, TX USA.

Dandoy, Christopher E. (författare): Univ Cincinnati, Sch Med, Cincinnati Childrens Hosp Med Ctr, Dept Biostat Epidemiol & Informat, Cincinnati, OH USA.

Marks, David, I (författare): Univ Hosp Bristol NHS Trust, Adult Bone Marrow Transplant, Bristol, Avon, England.

Lazarus, Hillard M. (författare): Case Western Reserve Univ, Univ Hosp Cleveland Med Ctr, Dept Biostat Epidemiol & Informat, Cleveland, OH 44106 USA.

Abdel-Azim, Hisham (författare): Univ Southern Calif, Keck Sch Med, Childrens Hosp Los Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Los Angeles, CA 90007 USA.

Bitan, Menachem (författare): Tel Aviv Sourasky Med Ctr, Dept Pediat Hematol Oncol, Tel Aviv, Israel.

Diaz, Miguel Angel (författare): Hosp Infantil Univ Nino Jesus, Dept Hematol Oncol, Madrid, Spain.

Olsson, Richard F. (författare): Uppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD),Karolinska Inst, Dept Lab Med, Stockholm, Sweden

Gergis, Usama (författare): Thomas Jefferson Univ, Div Hematol Malignancies, Dept Med Oncol, Philadelphia, PA 19107 USA.

Seber, Adriana (författare): Hosp Samaritano Sao Paulo, Dept Biostat Epidemiol & Informat, Sao Paulo, Brazil.

Wirk, Baldeep (författare): Penn State Canc Inst, Bone Marrow Transplant Program, Hershey, PA USA.

LeMaistre, C. Fred (författare): Sarah Cannon Blood Canc Network, Nashville, TN USA.

Ustun, Celalettin (författare): Rush Univ, Div Hematol Oncol Cell Therapy, Chicago, IL 60612 USA.

Duncan, Christine (författare): Boston Childrens Hosp, Dept Pediat Oncol, Boston, MA USA.;Dana Farber Canc Inst, Boston, MA 02115 USA.

Rizzieri, David (författare): Duke Univ, Div Hematol Malignancies & Cellular Therapy, Durham, NC USA.

Szwajcer, David (författare): Univ Manitoba, Canc Care Manitoba, Winnipeg, MB, Canada.

Fagioli, Franca (författare): Regina Margherita Children Hosp, City Sci & Hlth Turin, Stem Cell Transplantat & Cell Therapy Div, Pediat Oncohematol, Turin, Italy.

Frangoul, Haydar (författare): Childrens Hosp TriStar Centennial Med Ctr, Dept Biostat Epidemiol & Informat, Nashville, TN USA.;Sarah Cannon Res Inst, Nashville, TN USA.

Knight, Jennifer M. (författare): Med Coll Wisconsin, Dept Psychiat, Milwaukee, WI 53226 USA.

Kamble, Rammurti T. (författare): Baylor Coll Med, Ctr Cell & Gene Therapy, Div Hematol & Oncol, Houston, TX 77030 USA.

Mehta, Paulette (författare): Cent Arkansas Vet Healthcare Syst, Little Rock, AR USA.;Univ Arkansas Med Sci, Little Rock, AR 72205 USA.

Schears, Raquel (författare): Univ Cent Florida, Dept Emergency Med, Orlando, FL USA.

Satwani, Prakash (författare): Columbia Univ, Dept Pediat, Med Ctr, Div Pediat Hematol Oncol & Stem Cell Transplantat, New York, NY 10027 USA.

Pulsipher, Michael A. (författare): Univ Southern Calif, Canc & Blood Dis Inst, Childrens Hosp Los Angeles, Sect Transplantat & Cellular Therapy,Keck Sch Med, Los Angeles, CA 90007 USA.

Aplenc, Richard (författare): Univ Penn, Dept Biostat Epidemiol & Informat, Philadelphia, PA 19104 USA.

Saber, Wael (författare): Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.

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Emory Univ, Childrens Healthcare Atlanta, Aflac Canc & Blood Disorder Ctr, Atlanta, GA 30322 USA Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Inst Hlth & Equ, Div Biostat, Milwaukee, WI 53226 USA. (creator_code:org_t)

Elsevier BV, 2020
2020
Engelska.
Ingår i: Biology of blood and marrow transplantation. - : Elsevier BV. - 1083-8791 .- 1523-6536. ; 26:9, s. 1747-1756

Relaterad länk:: https://doi.org/10.1...; visa fler...; https://urn.kb.se/re...; https://doi.org/10.1...; http://kipublication...; visa färre...

Tidskriftsartikel (refereegranskat)

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Allogeneic hematopoietic stem cell transplantation (alloHCT) may be associated with significant morbidity and mortality, resulting in increased healthcare utilization (HCU). To date, no multicenter comparative cost analyses have specifically evaluated alloHCT in children with acute leukemia. In this retrospective cohort study, we examined the relationship between survival and HCU while investigating the hypothesis that matched sibling donor (MSD) alloHCT has significantly lower inpatient HCU with unrelated donor (URD) alloHCT, and that among URDs, umbilical cord blood (UCB) alloHCT will have higher initial utilization but lower long-term utilization. Clinical and transplantation outcomes data from the Center for International Blood and Marrow Transplant Research (CIBMTR) were merged with inpatient cost data from the Pediatric Health Information System (PHIS) database using a probabilistic merge methodology. The merged dataset comprised US patients age 1 to 21 years who underwent alloHCT for acute leukemia between 2004 and 2011 with comprehensive CIBMTR data at a PHIS hospital. AlloHCT was analyzed by donor type, with specific analysis of utilization and costs using PHIS claims data. The primary outcomes of overall survival (OS), leukemia-free survival (LFS), and inpatient costs were evaluated using Kaplan-Meier curves and Cox and Poisson models. A total of 632 patients were identified in both the CIBMTR and PHIS data. The 5-year LFS was 60% for MSD alloHCT, 47% for well-matched matched unrelated donor bone marrow (MUD) alloHCT, 48% for mismatched unrelated donor alloHCT, and 45% for UCB alloHCT (P = .09). Total adjusted costs were significantly lower for MSD alloHCT versus MUD alloHCT by day 100 (adjusted cost ratio [ACR], .73; 95% confidence interval [CI], .62 to .86; P < .001), and higher for UCB alloHCT versus MUD alloHCT (ACR, 1.27; 95% CI, 1.11 to 1.45; P < .001). By 2 years, total adjusted costs remained significantly lower for MSD alloHCT compared with MUD alloHCT (ACR, .67; 95% CI, .56 to .81; P < .001) and higher for UCB alloHCT compared with MUD alloHCT (ACR, 1.25; 95% CI, 1.02 to 1.52; P = .0280). Our data show that UCB and MUD alloHCT provide similar survival outcomes; however, MUD alloHCT has a significant advantage in cost by day 100 and 2 years. More research is needed to determine whether the cost difference among URD alloHCT approaches remains significant with a larger sample size and/or beyond 2 years post-alloHCT.

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Hematologi

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The Impact of Donor Type on Outcomes and Cost of Allogeneic Hematopoietic Cell Transplantation for Pediatric Leukemia : A Merged Center for International Blood and Marrow Transplant Research and Pediatric Health Information System Analysis

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