Quality of Life Assessment and Cost‑utility Analysis of Initial Chemotherapy for Patients with Non‑Hodgkin's Lymphoma: A Prospective Analysis

Overview

Journal Oncol Lett

Specialty Oncology

Date 2024 Jul 25

PMID 39049984

Authors

Kazuhide Tanaka

Masahiro Yasuda

Tomoya Tachi

Yuta Teshigawara

Seiji Inoue

Yoko Ino

Junichi Kitagawa

Yoshihiro Noguchi

Tomoaki Yoshimura

Hitomi Teramachi

Senji Kasahara

Affiliations

Soon will be listed here.

Abstract

Chemotherapy has helped prolong survival in patients with malignant lymphoma, enhancing their quality of life (QOL). Despite the eventual decline in the QOL of patients, the impact of initial chemotherapy remains poorly understood. A prospective patient-reported QOL survey among patients with malignant lymphoma receiving initial chemotherapy was conducted, targeting those treated at Gifu Municipal Hospital (Gifu, Japan) between January 2021 and December 2022. Surveys were conducted pre- and post-chemotherapy based on the EuroQol 5 dimensions. Drug costs were calculated using official prices and analyzed from the cost payer's perspective via cost-utility analysis. Among the 60 patients included in the present study, 28 had diffuse large B-cell lymphoma. Cyclophosphamide, doxorubicin, vincristine, prednisolone ± rituximab therapy was the most common treatment (38 patients) and demonstrated superior cost-effectiveness due to its lowest cost and change in utility value. Initial chemotherapy for patients with malignant lymphoma generally improved the QOL. Clinical trial registration: UMIN000042868 (registered on December 28, 2020).

References

Aogi K, Takeuchi H, Saeki T, Aiba K, Tamura K, Iino K . Optimizing antiemetic treatment for chemotherapy-induced nausea and vomiting in Japan: Update summary of the 2015 Japan Society of Clinical Oncology Clinical Practice Guidelines for Antiemesis. Int J Clin Oncol. 2020; 26(1):1-17. PMC: 7788035. DOI: 10.1007/s10147-020-01818-3. View

Johnsen A, Tholstrup D, Petersen M, Pedersen L, Groenvold M . Health related quality of life in a nationally representative sample of haematological patients. Eur J Haematol. 2009; 83(2):139-48. PMC: 2730555. DOI: 10.1111/j.1600-0609.2009.01250.x. View

Devita Jr V, Canellos G, Chabner B, Schein P, Hubbard S, Young R . Advanced diffuse histiocytic lymphoma, a potentially curable disease. Lancet. 1975; 1(7901):248-50. DOI: 10.1016/s0140-6736(75)91142-3. View

Ohno S, Shoji A, Hatake K, Oya N, Igarashi A . Cost-effectiveness analysis of treatment regimens with obinutuzumab plus chemotherapy in Japan for untreated follicular lymphoma patients. J Med Econ. 2020; 23(10):1130-1141. DOI: 10.1080/13696998.2020.1791890. View

El Haidari R, Anota A, Dabakuyo-Yonli T, Guillemin F, Conroy T, Velten M . Utility values and its time to deterioration in breast cancer patients after diagnosis and during treatments. Qual Life Res. 2022; 31(10):3077-3085. DOI: 10.1007/s11136-022-03157-4. View

Omachi K . JSH practical guidelines for hematological malignancies, 2018: II. Lymphoma-overview. Int J Hematol. 2019; 110(1):3-10. DOI: 10.1007/s12185-019-02676-0. View

Oerlemans S, Issa D, van den Broek E, Nijziel M, Coebergh J, Huijgens P . Health-related quality of life and persistent symptoms in relation to (R-)CHOP14, (R-)CHOP21, and other therapies among patients with diffuse large B-cell lymphoma: results of the population-based PHAROS-registry. Ann Hematol. 2014; 93(10):1705-15. DOI: 10.1007/s00277-014-2099-8. View

Mounier N, Anthony S, Busson R, Thieblemont C, Ribrag V, Tilly H . Long-term fatigue in survivors of non-Hodgkin lymphoma: The Lymphoma Study Association SIMONAL cross-sectional study. Cancer. 2019; 125(13):2291-2299. DOI: 10.1002/cncr.32040. View

Solal-Celigny P . Follicular Lymphoma International Prognostic Index. Curr Treat Options Oncol. 2006; 7(4):270-5. DOI: 10.1007/s11864-006-0036-3. View

10.

Ardeshna K, Qian W, Smith P, Braganca N, Lowry L, Patrick P . Rituximab versus a watch-and-wait approach in patients with advanced-stage, asymptomatic, non-bulky follicular lymphoma: an open-label randomised phase 3 trial. Lancet Oncol. 2014; 15(4):424-35. DOI: 10.1016/S1470-2045(14)70027-0. View

11.

Parker P, Baile W, de Moor C, Cohen L . Psychosocial and demographic predictors of quality of life in a large sample of cancer patients. Psychooncology. 2003; 12(2):183-93. DOI: 10.1002/pon.635. View

12.

Wilson W, Grossbard M, Pittaluga S, Cole D, Pearson D, Drbohlav N . Dose-adjusted EPOCH chemotherapy for untreated large B-cell lymphomas: a pharmacodynamic approach with high efficacy. Blood. 2002; 99(8):2685-93. DOI: 10.1182/blood.v99.8.2685. View

13.

Hasegawa M, Komoto S, Shiroiwa T, Fukuda T . Formal Implementation of Cost-Effectiveness Evaluations in Japan: A Unique Health Technology Assessment System. Value Health. 2020; 23(1):43-51. DOI: 10.1016/j.jval.2019.10.005. View

14.

Doorduijn J, Buijt I, Holt B, Steijaert M, Uyl-de Groot C, Sonneveld P . Self-reported quality of life in elderly patients with aggressive non-Hodgkin's lymphoma treated with CHOP chemotherapy. Eur J Haematol. 2005; 75(2):116-23. DOI: 10.1111/j.1600-0609.2005.00438.x. View

15.

Romaguera J, Fayad L, Rodriguez M, Broglio K, Hagemeister F, Pro B . High rate of durable remissions after treatment of newly diagnosed aggressive mantle-cell lymphoma with rituximab plus hyper-CVAD alternating with rituximab plus high-dose methotrexate and cytarabine. J Clin Oncol. 2005; 23(28):7013-23. DOI: 10.1200/JCO.2005.01.1825. View

16.

Zhou Z, Sehn L, Rademaker A, Gordon L, LaCasce A, Crosby-Thompson A . An enhanced International Prognostic Index (NCCN-IPI) for patients with diffuse large B-cell lymphoma treated in the rituximab era. Blood. 2013; 123(6):837-42. PMC: 5527396. DOI: 10.1182/blood-2013-09-524108. View

17.

Paunescu A, Copie C, Malak S, Le Gouill S, Ribrag V, Bouabdallah K . Quality of life of survivors 1 year after the diagnosis of diffuse large B-cell lymphoma: a LYSA study. Ann Hematol. 2021; 101(2):317-332. PMC: 8494456. DOI: 10.1007/s00277-021-04689-4. View

18.

Martin P, Chadburn A, Christos P, Weil K, Furman R, Ruan J . Outcome of deferred initial therapy in mantle-cell lymphoma. J Clin Oncol. 2009; 27(8):1209-13. DOI: 10.1200/JCO.2008.19.6121. View

19.

Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D . Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011; 20(10):1727-36. PMC: 3220807. DOI: 10.1007/s11136-011-9903-x. View

20.

Ardeshna K, Smith P, Norton A, Hancock B, Hoskin P, MacLennan K . Long-term effect of a watch and wait policy versus immediate systemic treatment for asymptomatic advanced-stage non-Hodgkin lymphoma: a randomised controlled trial. Lancet. 2003; 362(9383):516-22. DOI: 10.1016/s0140-6736(03)14110-4. View