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ORIGINAL ARTICLE
Year : 2012  |  Volume : 37  |  Issue : 2  |  Page : 96-101

Cost-effectiveness of postremission intensive chemotherapy in comparison with allogeneic stem-cell transplantation in adult Egyptian patients with acute myeloid leukemia


Internal Medicine Department, Hematology and Bone Marrow Transplant Units, Ain Shams University, Cairo, Egypt

Correspondence Address:
Walaa Ali ELSalakawy
16 abdellatif elfaham St. Menniat Elsereg, Alkhalaphawy, Shoubra, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.7123/01.EJH.0000415251.75716.cb

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Background

We assessed the cost-effectiveness of postremission high-dose arabinoside (HiDAC)-based chemotherapy in comparison with allogeneic stem-cell transplantation (alloSCT)-based therapy in adult Egyptian patients with acute myeloid leukemia at either an intermediate or a poor cytogenetic risk.

Patients and methods

Forty young patients at either an intermediate or a poor cytogenetic risk received postremission intensive therapy (20 HiDAC-based/20 alloSCT-based). We analyzed the overall survival, disease-free survival, and cost effectiveness in both groups.

Results

Patients were followed up over a period of 60 months. The mean overall survival was 36.32 months for the HiDAC-based group, whereas it was 48.8 months in the alloSCT-based group. The mean disease-free survival was 24.8 months in the HiDAC-based group, whereas it was 51.5 months in the alloSCT-based group. The mean total cost in the HiDAC-based group was 51 300 Egyptian pounds (nearly US$9000), whereas it was 88 250 Egyptian pounds (nearly US$15 482) in the alloSCT-based group.

Conclusion

For the postremission therapy in young acute myeloid leukemia patients at either an intermediate or a poor cytogenetic risk, HiDAC-based chemotherapy is less costly and less effective, whereas alloSCT is more costly and more effective in maintaining patients in durable remission.



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