Burden of Relapse Following Allogeneic Hematopoietic Stem Cell Transplantation on Health Care Resource Utilization in the Management of Acute Leukemia and Myelodysplastic Syndrome
Notice bibliographique
Résumé
Abstract Background: Allogeneic Hematopoietic Stem Cell Transplantation (aHSCT) represents the only curative modality for unfavorable acute leukemia (AL) and myelodysplastic syndrome (MDS). Despite its curative intent, a significant number of recipients relapse. There is no standardized approach for the management of relapse following transplants and therapeutic options vary among centers, which represent a major challenge. Post transplant relapse is usually associated with a poor outcome while the impact of the treatment choice on health care resource utilization and survival is unknown. The objective of this study was to measure the health care resource utilization for the management of relapse following AHSCT and how the treatment choice impacted on survival. Methods: A retrospective medical chart review was conducted at H™pital Maisonneuve-Rosemont (HMR) after research and ethic committee approval. Patients were selected using the Hematopoietic Stem Cell Transplant (HSCT) program database. Eligible patients were diagnosed with AL or MDS and relapsed following a HLA identical aHSCT between January 1st 2011 and December 31st 2014. Patients' and disease characteristics as well as relapse-related health care resource utilization were collected from the date of transplant relapse diagnosis until death or last follow-up. Results: During the study period, of the 645 HSCT performed at HMR, 303 were allogeneic. A total of 36 patients who relapsed met the inclusion criteria and were included in the survival analysis. Healthcare resource utilization analysis was conducted on the 25 patients for whom complete records were available. Patients' characteristics at relapse, mean health care resource utilization per patient and survival by treatment choice are presented in tables 1, 2 and 3 respectively. The mean time from relapse to death was 10.6 months (SD=13.2). Relapse-related hospitalization duration represented on average 20.3% of patients' follow-up period (SD=26.0). For a mean follow-up time of 9.5 months (ranged from 6 days to 4.8 years), the mean number of relapse-related hospitalization was 2.2 per patient (SD=2.6). The mean length of stay was 40.4 days per patient (SD=54.5). The mean hematologist consultation number was 32.4 per patient (SD=37.3 Conclusion: Relapse following AHSCT is associated with a poor prognosis and survival and significant use of health care resources. Aggressive treatment rarely leads to a second transplant. Innovative approaches should be developed to address this unmet medical need. Healthcare resources devoted to the care of patients in relapse post AHSCT provide a comparative basis for the development of cellular therapy. Disclosures No relevant conflicts of interest to declare.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».