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

efficacy results with a well-tolerated safety profile. Aims. This study
explores the cost effectiveness of imatinib plus CC versus CC alone in
adult Ph + ALL patients. Methods. A Markov model simulated a hypothetical
cohort of adult Ph + ALL patients receiving imatinib plus CC or CC
alone. The model included three states: alive without disease progression
(DFS), alive with disease progression (DS), and death. State transition
probabilities were derived from the published literature. In the
absence of relevant data pertaining to Ph + ALL, assumptions about costs
and utilities were derived from a cost analysis of CML. Only direct medical
costs were included, adopting a UK healthcare payer perspective. All
outcomes were discounted. Costs were adjusted to £2006. Results. The
model projects that the total discounted survival was 1.10 years for CC
and 4.31 years for imatinib+CC. Total discounted disease free survival
was 0.76 year for CC and 2.77 years for imatinib + CC. The total discounted
quality adjusted life years (QALY) were 0.85 v. 3.28 for CC and
imatinib + CC, respectively. Thus, the net incremental gain in discounted
quality adjusted survival was 2.43 QALYs. The monthly costs of DFS and
DS were estimated at £123 and £417, respectively. The net costs associated
with imatinib were £51,757 for the UK. The incremental cost per
QALY of imatinib+CC v. CC alone was approximately £21,299 (i.e.,
£51,757 divided by 2.43 QALYs). Summary / Conclusions. For adult ALL
patients with poor prognosis due to Ph+ALL, our exploratory analysis
suggests that, given the underlying data and assumptions, adding imatinib
to conventional chemotherapy regimens is cost-effective compared
to chemotherapy alone from the UK perspective.
1117
BORTEZOMIB PLUS DEXAMETHASONE AS INDUCTION THERAPY IN NEWLY DIAGNOSED
MULTIPLE MYELOMA: A PRELIMINARY STUDY IN THAI PATIENTS
T. Na Nakorn, 1 P. Watanaboonyongcharoen, 1 P. Niparuck, 2
S. Chancharunee, 2 T. Intragumtornchai1 1 2 Chulalongkorn University, BANGKOK, Thailand; Ramathibodi Hospital,
BANGKOK, Thailand
Background. Standard induction chemotherapy in myeloma can induce
complete remission in only about 5-10% of cases. The most effective
treatment, so far, is high-dose chemotherapy followed by autologous
stem cell transplant. Incorporation of novel antimyeloma agents into the
induction regimen should improve the outcomes, especially in patients
who cannot receive high-dose chemotherapy. Aims. We assessed the
response rate and factors that may predict the response in 20 newly
diagnosed myeloma patients who were treated with bortezomib plus
dexamethasone (VelDEX) as an induction therapy before undergoing
peripheral stem cell collection and autologous stem cell transplant. Methods.
Bortezomib 1.3 mg/m 2 was administered intravenously on days 1,
4, 8 and 11, along with dexamethasone 40 mg orally on day 1-4 and 8-
11 of a 21-day cycle for 4 cycles. The complete evaluation was done after
the fourth cycle of VelDEX. Responses were defined according to the
European Group for Blood and Marrow Transplantation criteria. The
response rate was then compared with the historical cohort of patients
who were treated with VAD (vincristine, adriamycin and dexamethsone)
regimen at the same institution. Results. 19 out of 20 patients
enrolled were eligible for evaluation. All but one completed four cycles
of VelDEX. The objective responses were achieved in 15 patients (79%),
including complete remission in 7 patients. On an intent-to-treat basis,
response rate for complete remission, partial response, minimal response,
stable disease, progressive disease were 37%, 42%, 11%, 5%, and 5%
respectively. Comparing with the cohort of 30 patients treated with
VAD regimen, VelDEX is superior in inducing complete remission (37%
vs. 10%, p