Contributions
Abstract: PB1748
Type: Publication Only
Session title: Quality of life, palliative care, ethics and health economics
Background
Immunochemotherapy-regime R-CHOP is the standard firstline (1L) treatment for patients (pts) with diffuse large B-cell lymphoma, approximately 30 - 50% of pts will not be cured by 1L. Especially pts with an early relapse <12 months (m) after 1L have a poor prognosis for cure. Only limited information exists on clinical outcomes, treatment patterns, resource consumption and costs in routine care of early-relapsed DLBCL-pts in Germany.
Aims
Therefore, we initiated a study to provide information on aforementioned variables.
Methods
Retrospective single center observational feasibility study. Data sources were claims data and data from medical records (2007-2018) from a German tertiary teaching hospital. Early relapse was defined as <17m after initial diagnosis (ID). Treatment-patterns were analyzed in regimens per line. Outcome-parameter: resource-use (inpatient stay; cumulated over patient career), costs (cumulated over patient career) and documented death (dd). Costs were evaluated from statutory health insurance perspective. Inclusion criteria: age ≥18 years, diagnosis of relapsed DLBCL (ICD: C83.3). Exclusion criteria: age <18 years, additional active malignancies.
Results
We identified 84 pts with relapse after 1L. In total 44 pts (52%) relapsed within 17 m after ID. Mean age at ID: 59 y (median: 63); n = 26 (59%) were male. Ann-Abor stage at ID: 15 pts I-II; 29 pts III-IV. 28 pts were in 2L; 14 pts received 3L, 1 pt in 4L and 1 pt 5L. Outcomes for 2L pts: 17 in complete remission incl. follow-up (CR), 11 documented deaths (dd). 3L pts: n=8 in CR, 6 dd. 4L: n=1 in CR. 5L: n=1 dd. Mean duration of inpatient stay per patient (ppt) in 2L was 45 days (median: 43; range 3 – 132); in 3L: 74d (80; 33 – 122); 4L: 137d; 5L: 183d. Following treatment-patterns refer on pts in 2L (n=28): 10 pts received Immuno-chemotherapy (I-chemo), 6 pts I-chemo + autologous-stem cell transplantation (auto-SCT), 4 pts a chemo, 4 pts a radiation, 2pts a chemo + auto-SCT and 2 pts a I-chemo + radiation. Mean total costs (€) ppt in 2L: 47.300 (median: 40.300; 6.500 – 166.000); 85.000 for 3L pts (77.300; 33.700 – 214.000); 4L: 200.000 and 5L: 163.000.
Conclusion
The results show that an early-relapse results in a high patient and economic burden: various therapies, long inpatient-stay, significant costs and documented deaths. The highly individual treatment approaches or the huge ranges in costs are indicators that it is difficult to calculate DLBCL-treatment with averages in variables. Comprehensive cost and outcome analyses in DLBCL treatment are needed. The presented costs may underestimate the total hospital costs for patients with DLBCL treatment, because exclusively inpatient claims data from the hematology/oncology department were taken into consideration. Costs from the radiation center and the outpatient center are not included.
Keyword(s):
Abstract: PB1748
Type: Publication Only
Session title: Quality of life, palliative care, ethics and health economics
Background
Immunochemotherapy-regime R-CHOP is the standard firstline (1L) treatment for patients (pts) with diffuse large B-cell lymphoma, approximately 30 - 50% of pts will not be cured by 1L. Especially pts with an early relapse <12 months (m) after 1L have a poor prognosis for cure. Only limited information exists on clinical outcomes, treatment patterns, resource consumption and costs in routine care of early-relapsed DLBCL-pts in Germany.
Aims
Therefore, we initiated a study to provide information on aforementioned variables.
Methods
Retrospective single center observational feasibility study. Data sources were claims data and data from medical records (2007-2018) from a German tertiary teaching hospital. Early relapse was defined as <17m after initial diagnosis (ID). Treatment-patterns were analyzed in regimens per line. Outcome-parameter: resource-use (inpatient stay; cumulated over patient career), costs (cumulated over patient career) and documented death (dd). Costs were evaluated from statutory health insurance perspective. Inclusion criteria: age ≥18 years, diagnosis of relapsed DLBCL (ICD: C83.3). Exclusion criteria: age <18 years, additional active malignancies.
Results
We identified 84 pts with relapse after 1L. In total 44 pts (52%) relapsed within 17 m after ID. Mean age at ID: 59 y (median: 63); n = 26 (59%) were male. Ann-Abor stage at ID: 15 pts I-II; 29 pts III-IV. 28 pts were in 2L; 14 pts received 3L, 1 pt in 4L and 1 pt 5L. Outcomes for 2L pts: 17 in complete remission incl. follow-up (CR), 11 documented deaths (dd). 3L pts: n=8 in CR, 6 dd. 4L: n=1 in CR. 5L: n=1 dd. Mean duration of inpatient stay per patient (ppt) in 2L was 45 days (median: 43; range 3 – 132); in 3L: 74d (80; 33 – 122); 4L: 137d; 5L: 183d. Following treatment-patterns refer on pts in 2L (n=28): 10 pts received Immuno-chemotherapy (I-chemo), 6 pts I-chemo + autologous-stem cell transplantation (auto-SCT), 4 pts a chemo, 4 pts a radiation, 2pts a chemo + auto-SCT and 2 pts a I-chemo + radiation. Mean total costs (€) ppt in 2L: 47.300 (median: 40.300; 6.500 – 166.000); 85.000 for 3L pts (77.300; 33.700 – 214.000); 4L: 200.000 and 5L: 163.000.
Conclusion
The results show that an early-relapse results in a high patient and economic burden: various therapies, long inpatient-stay, significant costs and documented deaths. The highly individual treatment approaches or the huge ranges in costs are indicators that it is difficult to calculate DLBCL-treatment with averages in variables. Comprehensive cost and outcome analyses in DLBCL treatment are needed. The presented costs may underestimate the total hospital costs for patients with DLBCL treatment, because exclusively inpatient claims data from the hematology/oncology department were taken into consideration. Costs from the radiation center and the outpatient center are not included.
Keyword(s):