Adverse Events and Economic Burden Among Patients Receiving Systemic Treatment for Mantle Cell Lymphoma: A Real-World Retrospective Cohort Study

Anticancer Res. 2021 Feb;41(2):927-936. doi: 10.21873/anticanres.14846.

Abstract

Background/aim: Limited published real-world data describe adverse events (AEs) among patients treated for mantle-cell lymphoma (MCL). The aim of this retrospective study was to describe treatment patterns, AEs, and associated healthcare costs.

Patients and methods: Patients had two or more claims coded for MCL diagnosis, the first claim date (07/01/2012-05/31/2017) was the index date. Patients with pre-index MCL diagnosis or systemic treatment, or hematopoietic stem cell transplantation were excluded. Cohorts by regimen were followed for up to three lines of therapy.

Results: Patients (n=395; median age 72 years; 31% female) were observed over a total of 576 lines of therapy, the most common being bendamustine plus rituximab; rituximab monotherapy; R-CHOP; and ibrutinib. The most frequent AEs were hypertension (40.5%), anemia (37.7%), and infection (36.1%). However, hepatotoxicity ($19,645), stroke ($18,893), and renal failure ($9,037) were associated with the highest medical costs per patient per month.

Conclusion: Among patients receiving common systemic treatments for MCL, AEs occurred frequently; some imposed substantial inpatient care costs.

Keywords: Mantle-cell lymphoma; adverse events; healthcare costs; retrospective cohort study.

MeSH terms

  • Adenine / adverse effects
  • Adenine / analogs & derivatives
  • Adenine / economics
  • Adenine / therapeutic use
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / economics
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bendamustine Hydrochloride / adverse effects
  • Bendamustine Hydrochloride / economics
  • Bendamustine Hydrochloride / therapeutic use
  • Chemical and Drug Induced Liver Injury / economics*
  • Cyclophosphamide / adverse effects
  • Cyclophosphamide / economics
  • Cyclophosphamide / therapeutic use
  • Doxorubicin / adverse effects
  • Doxorubicin / economics
  • Doxorubicin / therapeutic use
  • Female
  • Health Care Costs
  • Humans
  • Lymphoma, Mantle-Cell / drug therapy*
  • Male
  • Middle Aged
  • Piperidines / adverse effects
  • Piperidines / economics
  • Piperidines / therapeutic use
  • Prednisone / adverse effects
  • Prednisone / economics
  • Prednisone / therapeutic use
  • Renal Insufficiency / chemically induced
  • Renal Insufficiency / economics*
  • Retrospective Studies
  • Rituximab / adverse effects
  • Rituximab / economics
  • Rituximab / therapeutic use
  • Stroke / chemically induced
  • Stroke / economics*
  • Vincristine / adverse effects
  • Vincristine / economics
  • Vincristine / therapeutic use

Substances

  • Piperidines
  • R-CHOP protocol
  • ibrutinib
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Bendamustine Hydrochloride
  • Adenine
  • Prednisone