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• W4231847247 abstract "We recently completed a meta-analysis similar to that published by Yanada et al.1, 2 For our study, we used a nearly identical method of clinical trial selection (main source of clinical data, MEDLINE in PubMed version; time interval, January 2000 to June 2006) and included 4 controlled studies,3-6 all of which were cited in the article by Yanada et al. One point of strength of our meta-analysis is that our statistical model7 accounted for the length of follow-up and, thus, was able to generate a survival meta-analysis (inclusive of the construction of the 2 censored Kaplan–Meier meta-analytic curves for transplantation and chemotherapy, respectively). In their statistical model, Yanada et al considered only crude survival rates (with no adjustment for time); consequently, their results are exposed to a potential bias favoring transplantation, because the same statistical weight was given to early and late events (in a situation in which some early events, eg transplantation-related deaths, are more frequent in the experimental arm). Our survival meta-analysis (relative risk of death or recurrence, 0.79 in favor of transplantation; 95% confidence interval, 0.66–0.96; P = .017) provided results nearly identical to those of Yanada et al. In addition, our statistics allowed us to estimate the mean survival gain produced by transplantation (1.0 year per patient) and to carry out a preliminary cost-effectiveness analysis (cost per life year gained, €37,000, which is less than the conventional threshold of €50,000 or $50,000). In this assessment, information on costs (€82,000 and €45,000 per patient for transplantation and chemotherapy, respectively) was derived from Lee et al.8 In conclusion, our results are noteworthy, because, on the one hand, they confirm (with a different statistical model) the findings obtained by Yanada et al.1; and, on the other hand, they suggest that allogeneic transplantation has an acceptable cost-effectiveness profile. Benedetta Bartolozzi MD*, Alberto Bosi MD*, Cecilia Orsi PharmD , * Hematology Unit, University of Firenze, Careggi University Hospital, Firenze, Italy, Laboratory of Pharmacoeconomics, Pharmaceutical Service, Careggi University Hospital, Firenze, Italy." @default.
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• W4231847247 date "2007-01-01" @default.
• W4231847247 modified "2023-09-25" @default.
• W4231847247 title "Allogeneic hematopoietic stem cell transplantation as part of postremission therapy improves survival for adult patients with high-risk acute lymphoblastic leukemia" @default.
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• W4231847247 doi "https://doi.org/10.1002/cncr.22406" @default.
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