12th Congress of the European Hematology ... - Haematologica

12 th Congress of the European Hematology Association
term survival. Model robustness was tested using sensitivity analyses.
Outcomes were measured as incremental cost-effectiveness ratio (ICER)
including € per percentage (absolute) FN risk decreased, € per FN event
avoided, and € per life-year gained (LYG). Results. Pegfilgrastim was cost
saving compared with 11-day filgrastim (€9,011 vs. €12,211 for pegfilgrastim
vs. filgrastim). Compared with 6-day filgrastim, the ICER was
€15,817 per FN avoided or €158 per 1% decrease in absolute risk of FN.
Pegfilgrastim achieved 0.095 more LY at a moderate cost increase of
€1,898 (€9,011 vs. €7,113) per person, yielding an ICER of
€19,979/LYG. Results were sensitive to the assumption of RDI impact,
relative risk of FN for 6-day filgrastim vs. pegfilgrastim and study time
horizon. Summary/Conclusions. In Germany, pegfilgrastim was cost saving
compared with 11-day filgrastim, and was shown to be cost-effective
compared with filgrastim used for 6 days per cycle of CHOP-21
chemotherapy. To substantiate our results, more studies are needed on
the impact of RDI supported by G-CSF and its impact on long-term survival.
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ANALYSIS OF IN-HOSPITAL CAUSES OF DEATHS IN ADULT ACUTE LYMPHOBLASTIC
LEUKEMIA PATIENTS
P. Malhotra, N. Varma, U. Saikia, S. Kumari, J. Ahluwalia, S. Jain,
R. Das, S. Varma
PGIMER, CHANDIGARH, India
Background. The survival rates for adult acute lymphoblastic leukemia
(AALL) in developing countries are significantly lower than the developed
countries. Some of the reasons for poor results are due to early
deaths due to infection and bleeding due to constraints on resources.
Aims. We choose to analyse the causes of deaths in admitted patients
with AALL at a large tertiary care multispecialty hospital of north-west
India. Methods. We collected death summaries of all adult (age >12 years)
patients suffering from various hematological malignancies and who
died in the hospital from January 2002 till December 2005. The death
summaries were then reviewed including presenting complaints of the
patients, duration of illness before presenting to hospital, duration of
hospitalisation, microbiological cultures and possible causes of deaths.
Patients were divided into three groups depending upon their diagnosis
and disease status. Group I was newly diagnosed patients in whom the
diagnosis of ALL was made in this admission. Group II were those
patients who were previously diagnosed with ALL and who were in
remission and died during this hospitalisation. Group III were those
patients who were previously diagnosed with ALL but were in relapse.
Results. Out of 236 deaths that occurred during this 4 years period, AALL
constituted 13.1% (31/236). The median age of the patients was 24 years
(range 13-55 years) and male female ration was 24:7. There were 16
patients in group I (median age 16.5 years), 6 patients in group II (median
age 27.5 years) and 9 patients were in group III (median age 31 years).
The median symptom duration was significantly higher in group I (30
days) as compared to group III (6 days) and II (2.5 days ;( p