title: Economic analysis of blood product transfusions according to the treatment of acute myeloid leukemia in the elderly.
abstract: BACKGROUND
  Blood transfusion requirement represents one of the most significant cost driver associated with acute myeloid leukemia (AML). Low-intensity treatments (low-dose cytarabine, hypomethylating agents) have the potential to reduce transfusion dependence, and improve health-related quality of life.
  
  
  METHODS
  We assessed the cost-effectiveness of treatment types regarding blood product transfusions in a cohort of 214 AML patients aged ≥ 70 years.
  
  
  RESULTS
  Analyzes did not indicate any significant overall survival (OS) advantage of intensive chemotherapy comparatively to low-intensity treatment. The difference was significant when compared to best supportive care (BSC) (P<0.0001). Blood products transfusion cost per patient was 1.3 times lower with low-intensity therapy and 2.7 times lower with BSC than with intensive chemotherapy. Mean transfusion cost per patient according to OS varied from 2.4 to 1.3 times less with low-intensity treatment comparatively to intensive chemotherapy for patients having OS ≤ 13.3 months. Costs varied from 3.5 to 2.6 times less with BSC comparatively to intensive chemotherapy. In contrast, mean transfusion costs were comparable among treatments for patients with OS>13.3 months.
  
  
  CONCLUSIONS
  Low-intensity treatments represent a cost-effective alternative to BSC and require a reduced number of transfused blood products comparatively to intensive chemotherapy, while OS was not significantly different.
authors.affiliation: Hospices civils de Lyon, Edouard-Herriot Hospital, Lyon, France; Croix-Rousse Hospital, Lyon, France.
authors.forename: G
authors.initials: G
authors.lastname: Cannas
authors.affiliation: Hospices civils de Lyon, Edouard-Herriot Hospital, Lyon, France.
authors.forename: J
authors.initials: J
authors.lastname: Fattoum
authors.affiliation: Hospices civils de Lyon, Edouard-Herriot Hospital, Lyon, France.
authors.forename: M
authors.initials: M
authors.lastname: Boukhit
authors.affiliation: Hematology, hospices civils de Lyon, Lyon-Sud Hospital, pavillon Marcel-Bérard, bâtiment 1G, 69495 Pierre-Bénite, France. Electronic address: xavier.thomas@chu-lyon.fr.
authors.forename: X
authors.initials: X
authors.lastname: Thomas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008297:Male; D012189:Retrospective Studies
keywords: Acute myeloid leukemia; Blood transfusion; Cost-effectiveness; Coût-efficacité; Leucémie aiguë myéloïde; Prognosis; Pronostic; Therapy; Traitement; Transfusion sanguine