About this item:

90 Views | 56 Downloads

Author Notes:

Correspondence: Susan K. Parsons, Institute for Clinical Research and Health Policy Studies, Tufts MC, 800 Washington St., #345, Boston, MA 02111, USA. E-mail: sparsons@tuftsmedicalcenter.org

Andrew M. Evens, Rutgers Cancer Institute of New Jersey, Division of Blood Disorders, 195 Little Albany St, New Brunswick, NJ 08901, USA. E-mail: andrew.evens@rutgers.edu

Author contributions: SKP, MJK, JTC, DC, AME: designed research, performed research, analysed data, and wrote the paper.

SMC, TOH, KMK, FGK, TJH, AJK, PJ, RMM, JR: analysed data and wrote the paper.

Acknowledgements: The authors acknowledge Rachel Murphy-Banks’ editorial assistance in preparing the manuscript.

Disclosures: The authors declare no potential conflicts of interest.

Subjects:

Research Funding:

This project was funded in part by a research grant from the Leukemia & Lymphoma Society (Parsons/Henderson, Dual PIs).

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Hematology
  • simulation modelling
  • Hodgkin lymphoma
  • decision making
  • health-related quality of life
  • late effects of therapy
  • CHILDHOOD-CANCER SURVIVOR
  • CHILDRENS ONCOLOGY GROUP
  • DOSE-RESPONSE RELATIONSHIP
  • EORTC/LYSA/FIL H10 TRIAL
  • RADIATION-THERAPY
  • BREAST-CANCER
  • 2ND CANCER
  • FIELD RADIOTHERAPY
  • CLINICAL-TRIALS
  • INVOLVED-FIELD

Early-stage Hodgkin lymphoma in the modern era: simulation modelling to delineate long-term patient outcomes

Show all authors Show less authors

Tools:

Journal Title:

British Journal of Haematology

Volume:

Volume 182, Number 2

Publisher:

, Pages 212-221

Type of Work:

Article | Final Publisher PDF

Abstract:

We developed a novel simulation model integrating multiple data sets to project long-term outcomes with contemporary therapy for early-stage Hodgkin lymphoma (ESHL), namely combined modality therapy (CMT) versus chemotherapy alone (CA) via18F-fluorodeoxyglucose positron emission tomography response-adaption. The model incorporated 3-year progression-free survival (PFS), probability of cure with/without relapse, frequency of severe late effects (LEs), and 35-year probability of LEs. Furthermore, we generated estimates for quality-adjusted life years (QALYs) and unadjusted survival (life years, LY) and used model projections to compare outcomes for CMTversusCA for two index patients. Patient 1: a 25-year-old male with favourable ESHL (stage IA); Patient 2: a 25-year-old female with unfavourable ESHL (stage IIB). Sensitivity analyses assessed the impact of alternative assumptions for LE probabilities. For Patient 1, CMT was superior to CA (CMT incremental gain = 0·11 QALYs, 0·21 LYs). For Patient 2, CA was superior to CMT (CA incremental gain = 0·37 QALYs, 0·92 LYs). For Patient 1, the advantage of CMT changed minimally when the proportion of severe LEs was reduced from 20% to 5% (0·15 QALYs, 0·43 LYs), whereas increasing the severity proportion for Patient 2's LEs from 20% to 80% enhanced the advantage of CA (1·1 QALYs, 6·5 LYs). Collectively, this detailed simulation model quantified the long-term impact that varied host factors and alternative contemporary treatments have in ESHL.

Copyright information:

© 2018 The Authors. British Journal of Haematology published by John Wiley & Sons Ltd and British Society for Haematology.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/).

Creative Commons License

Export to EndNote