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Multicenter Study
. 2022 Jul;109(1):58-68.
doi: 10.1111/ejh.13769. Epub 2022 Apr 13.

Healthcare resource utilization trends in patients with acute myeloid leukemia ineligible for intensive chemotherapy receiving first-line systemic treatment or best supportive care: A multicenter international study

Tomoki Ito  1 , David Sanford  2 , Ciprian Tomuleasa  3 , Hui-Hua Hsiao  4 , Leonardo José Enciso Olivera  5 , Anoop Kumar Enjeti  6   7 , Alberto Gimenez Conca  8 , Teresa Bernal Del Castillo  9 , Larisa Girshova  10 , Maria Paola Martelli  11 , Birol Guvenc  12 , Cat N Bui  13 , Alex Delgado  14 , Yinghui Duan  13 , Belen Garbayo Guijarro  15 , Cynthia Llamas  13 , Je-Hwan Lee  16
Affiliations
Multicenter Study

Healthcare resource utilization trends in patients with acute myeloid leukemia ineligible for intensive chemotherapy receiving first-line systemic treatment or best supportive care: A multicenter international study

Tomoki Ito et al. Eur J Haematol. 2022 Jul.

Abstract

Objectives: This retrospective chart review examined real-world healthcare resource utilization (HRU) in patients with AML ineligible for intensive therapy who received first-line systemic therapy or best supportive care (BSC).

Methods: Data were collected anonymously on patients with AML who initiated first-line hypomethylating agents (HMA), low-dose cytarabine (LDAC), other systemic therapy, or BSC. HRU endpoints included hospitalizations, outpatient consultations, transfusions, and supportive care.

Results: Of 1762 patients included, 46% received HMA, 11% received LDAC, 17% received other systemic therapy, 26% received BSC; median treatment durations were 118, 35, 33, and 57 days, respectively. Most patients were hospitalized, most commonly for treatment administration, transfusion, or infection (HMA 82%, LDAC 93%, other systemic therapy 83%, BSC 83%). A median number of hospitalizations were 2-6 across systemic groups and two for BSC, with median durations of 8-18 days. Transfusion rates and outpatient consultations were highest for HMA (80% and 79%) versus LDAC (57% and 53%), other systemic therapy (57% and 63%), and BSC (71% and 66%). Antivirals/antibiotics and antifungals were used more frequently than growth factors (72-92%, 34-63%, and 7-27%, respectively).

Conclusion: Patients with AML ineligible for intensive therapy have high HRU; novel therapies are needed to alleviate this burden.

Keywords: AML; best supportive care; healthcare resource utilization; hypomethylating agents; low-dose cytarabine; low-intensity therapy.

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Conflict of interest statement

T. Ito: Advisory role for AbbVie and speaker honoraria for AbbVie, BMS, Novartis, Sanofi, Takeda. D. Sanford: Advisory role for AbbVie, Astellas, Novartis, Pfizer. C. Tomuleasa: No potential conflicts of interest are reported. H.‐H. Hsiao: Advisory role for AbbVie, Amgen, Janssen, Novartis, Pfizer. L. J. Enciso Olivera: No potential conflicts of interest are reported. A. K. Enjeti: Advisory role for AbbVie, Astellas, Novartis, Alexion, and Jazz Pharmaceuticals. Speaker for Alexion, Bayer, Sanofi. A. Gimenez Conca: No potential conflicts of interest are reported. T. Bernal del Castillo: No potential conflicts of interest are reported. L. Girshova: No potential conflicts of interest are reported. M. P. Martelli: Advisory role for AbbVie, Amgen, Celgene, Janssen, Jazz Pharmaceuticals, Novartis, Pfizer. Speaker honoraria for Amgen, Celgene, Janssen, Novartis. B. Guvenc: Advisory role for AbbVie. C. Bui, A. Delgado, Y. Duan, B. Garbayo Guijarro, C. Llamas: Employees of AbbVie and may hold stock or options. J.‐H. Lee: Advisory role for AbbVie, Astellas, Celgene, Janssen, Novartis.

Figures

FIGURE 1
FIGURE 1
Changes in treatment from first‐line to fourth‐line therapy. BSC, best supportive care; HMA, hypomethylating agent; LDAC, low‐dose cytarabine; N/A, not available
FIGURE 2
FIGURE 2
Reasons for hospitalizations during first‐line systemic therapy or BSC. †Percentages may sum up to >100% as multi‐selection was permitted. AML, acute myeloid leukemia; BSC, best supportive care; HMA, hypomethylating agent; LDAC, low‐dose cytarabine
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