Microcosting analysis of haematopoietic stem cell transplantation and chemotherapy with intermediate doses of cytarabine in the treatment of acute myeloid leukaemia

Author(s)

Chiesa, Sitania ; Rego, Eduardo Magalha ; Teich, Vanessa ; Madeira, Maria Isabel Ayrosa ; Pontes, Lorena Lobo de Figueiredo ; Traina, Fabiola ; Marani, Leticia Olops

• Document type: Journal article
• Source: Hematology, Transfusion and Cell Therapy; v. 46, p. 8-pg., 2024-12-01.

Abstract

Background: Acute myeloid leukaemia (AML) is considered a costly disease. Depending on the risk stratification, the patient may receive consolidation with cycles of intermediate doses of cytarabine, auto-HSCT or allo-HSCT according to availability in each service and the availability of a compatible donor. Literature data indicate that safety and effectiveness do not differ between consolidation therapy with intermediate-dose cytarabine or auto-HSCT, and so the cost can help physicians and health managers in their choice. Method: The cost of the second consolidation was compared in 18 to 60-year-old patients with de novo AML who were included in the International Consortium of Acute Myeloid Leukaemia (ICAML) protocol. Patients treated with auto-HSCT or intermediate doses of cytarabine (IDAC) were analysed during four years using the microcosting methodology. Results: The mean costs for auto-HSCT and IDAC were BRL$ 34,900.95 (range: 23,611.36 -41,229.59) and 15,231.64 (range: 6,546.36-23,253.53), respectively. The mean duration of in-hospital stay was 88.4 (93-133) and 94(50-153) days, respectively. The mean cost of the four cycles of treatment was BRL$ 114.212,78 for auto-HSCT and BRL$ 121.980,93 for the chemotherapy group. Regardless of the type of treatment, the input that had the greatest economic impact was hospital admission, mainly due to infections. Conclusion: Auto-HSCT had a lower average cost per patient and hospitalization rate than chemotherapy. (c) 2024 Published by Elsevier Espa & ntilde;a, S.L.U. on behalf of Associa & ccedil;& atilde;o Brasileira de Hematologia, Hemoterapia e Terapia Celular. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). (AU)

• FAPESP's process: 13/08135-2 - CTC - Center for Cell-Based Therapy
• Grantee: Dimas Tadeu Covas
• Support Opportunities: Research Grants - Research, Innovation and Dissemination Centers - RIDC