Real-world evidence on survival, adverse events, and health care burden in Medicare patients with mantle cell lymphoma.
Ravi K GoyalPreetesh JainSaurabh P NagarHannah LeShaum M KabadiKeith DavisJames A KayeXianglin L DuMichael L WangPublished in: Leukemia & lymphoma (2021)
Most data on overall survival (OS) and adverse events (AEs) in patients with mantle cell lymphoma (MCL) are from controlled trials; therefore, in this population-based study, we retrospectively assessed treatment patterns, OS, and AEs in MCL patients initiating systemic treatment during 2013-2015 using the United States Medicare claims database. Among 1390 eligible patients (median age = 74 years), chemoimmunotherapy with bendamustine/rituximab (BR) was the preferred choice in first-line (35.3%), followed by ibrutinib (33.5%), rituximab (9.1%), and rituximab/cyclophosphamide/doxorubicin/vincristine (R-CHOP) (6.8%). Twenty-four-month OS was 73% for BR; 47%, ibrutinib; 72%, rituximab; and 71%, R-CHOP. For the four most commonly used regimens, neutropenia, anemia, hypertension, and infection were the most frequent AEs. Patients with ≥3 AEs had nearly four times higher monthly costs than those with 0-2 AEs in the first observed therapy line. Findings demonstrate a substantial increase in the economic burden as the number of AEs increased among the Medicare MCL patients.
Keyphrases
- end stage renal disease
- diffuse large b cell lymphoma
- chronic kidney disease
- newly diagnosed
- healthcare
- ejection fraction
- prognostic factors
- chronic lymphocytic leukemia
- blood pressure
- emergency department
- stem cells
- machine learning
- mesenchymal stem cells
- artificial intelligence
- health insurance
- electronic health record
- hodgkin lymphoma
- patient reported
- high dose
- drug induced
- smoking cessation
- affordable care act