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Burden of hospitalization in acute lymphoblastic leukemia patients treated with Inotuzumab Ozogamicin versus standard chemotherapy treatment
Author(s) -
Marks David I.,
Oostrum Ilse,
Mueller Sabrina,
Welch Verna,
Vandendries Erik,
Loberiza Fausto R.,
Böhme Sarah,
Su Yun,
Stelljes Matthias,
Kantarjian Hagop M.
Publication year - 2019
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.2480
Subject(s) - medicine , lymphoblastic leukemia , refractory (planetary science) , chemotherapy , incidence (geometry) , dosing , pediatrics , leukemia , physics , astrobiology , optics
Background Inotuzumab Ozogamicin (INO), has demonstrated an improvement in overall survival, high rate of complete remission, favorable patient‐reported outcomes, and manageable safety profile vs standard of care (SoC; intensive chemotherapy) for relapsed/refractory (R/R) acute lymphoblastic leukemia (ALL) in the phase 3 INO‐VATE trial. With a one‐hour weekly dosing schedule, INO might be associated with lower healthcare system burden. This study analyses hospitalizations for INO vs SoC. Methods All patients receiving study treatment in the INO‐VATE trial were included. The days hospitalized during study treatment was calculated. Due to different treatment durations for INO and SoC (median of 3 vs 1 cycles), number of hospital days was mainly reported per observed patient month. Hospital days per patient month were analyzed for different treatment cycles, subgroups, and main reasons for hospitalization. Differences between treatments were analyzed by the incidence rate ratio (IRR). Results Overall, 82.9% and 94.4% INO and SoC patients experienced at least one hospitalization. The mean hospitalization days per patient month was 7.6 and 18.4 days for INO and SoC (IRR = 0.413, P  < .001), which corresponds to patients spending 25.0% and 60.5% of their treatment time in a hospital. Main hospitalization reasons were R/R ALL treatment (5.2 (INO) vs 14.0 (SoC) days, IRR = 0.368, P  < .001), treatment toxicities (1.4 vs 2.8 days, IRR = 0.516, P  < .001) or other reasons (1.0 vs 1.6 days, IRR 0.629, P  < .001). Conclusions Inotuzumab Ozogamicin treatment in R/R ALL is associated with a lower hospitalization burden compared with SoC. It is likely this lower burden has a favorable impact on healthcare budgets and cost‐effectiveness considerations.

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