Retrospective analysis of first-line treatment for follicular lymphoma based on outcomes and medical economics

Int J Clin Oncol. 2018 Apr;23(2):375-381. doi: 10.1007/s10147-017-1202-2. Epub 2017 Oct 24.

Abstract

Background: Follicular lymphoma (FL) is the most common type of non-Hodgkin lymphoma (NHL), with indolent progression. Several treatment options are selected, based not only on disease status, quality of life (QOL), and age of patient, but also on recent increasing medical costs. We retrospectively analysed the first-line treatment of FL with regard to treatment outcomes and medical economics, and discuss the appropriate strategies for FL.

Methods: Data on a total of 69 newly-diagnosed patients with FL was retrospectively collected from 2001 to 2015.

Results: The median age of the patients was 60 years and the median follow-up was 58 months. A total of 25 cases with FL were treated with R monotherapy, and 28 cases were treated with R-CHOP as first-line treatment. The factors affecting the decision of physicians to use R or R-CHOP treatment were serum level of lactate dehydrogenase (LDH) and disease stage. The first-line treatment-associated survival did not show any statistical differences between R and R-CHOP. The average hospitalization and average of all medical costs during the first-line treatment were 4.1 days (R) versus 55.7 days (R-CHOP), and JPY 1,707,693 (USD 15,324) (R) versus JPY 2,136,117 (USD 19,170) (R-CHOP), respectively.

Conclusion: R monotherapy for patients whose diseases show low tumor burden and who are not candidates for local treatment has benefits as a first-line treatment compared to R-CHOP, based on the patients' QOL and medical economics.

Keywords: Follicular lymphoma; Medical economics; Rituximab.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal, Murine-Derived / economics
  • Antibodies, Monoclonal, Murine-Derived / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / economics*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Costs and Cost Analysis
  • Cyclophosphamide / economics
  • Cyclophosphamide / therapeutic use
  • Doxorubicin / economics
  • Doxorubicin / therapeutic use
  • Drug Costs
  • Female
  • Humans
  • Immunotherapy / economics
  • Immunotherapy / methods
  • Lymphoma, Follicular / drug therapy*
  • Lymphoma, Follicular / economics
  • Lymphoma, Follicular / mortality*
  • Male
  • Middle Aged
  • Prednisone / economics
  • Prednisone / therapeutic use
  • Quality of Life
  • Retrospective Studies
  • Rituximab / administration & dosage
  • Rituximab / economics
  • Treatment Outcome
  • Vincristine / economics
  • Vincristine / therapeutic use

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • R-CHOP protocol
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone