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
Essam A Hassan, Amal M El Afifi, Nermeen Adel Nabih, Walaa Ali ELSalakawy
Internal Medicine Department, Hematology and Bone Marrow Transplant Units, Ain Shams University, Cairo, Egypt
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.