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

2.50
Hdl Handle:
http://hdl.handle.net/10541/621031
Title:
Early-stage Hodgkin lymphoma in the modern era: simulation modelling to delineate long-term patient outcomes.
Authors:
Parsons, S; Kelly, M; Cohen, J; Castellino, S; Henderson, T; Kelly, K; Keller, F; Henzer, T; Kumar, A; Johnson, P; Meyer, R; Radford, John A ( 0000-0001-7898-2786 ) ; Raemaekers, J; Hodgson, D; Evens, A
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) via 18 F-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.
Affiliation:
Department of Pediatrics, Tufts University School of Medicine, Boston, MA, USA
Citation:
Early-stage Hodgkin lymphoma in the modern era: simulation modelling to delineate long-term patient outcomes. 2018 Br J Haematol
Journal:
British Journal of Haematology
Issue Date:
29-Apr-2018
URI:
http://hdl.handle.net/10541/621031
DOI:
10.1111/bjh.15255
PubMed ID:
29707774
Type:
Article
Language:
en
Description:
Lymphoma Research Team
ISSN:
1365-2141
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorParsons, Sen
dc.contributor.authorKelly, Men
dc.contributor.authorCohen, Jen
dc.contributor.authorCastellino, Sen
dc.contributor.authorHenderson, Ten
dc.contributor.authorKelly, Ken
dc.contributor.authorKeller, Fen
dc.contributor.authorHenzer, Ten
dc.contributor.authorKumar, Aen
dc.contributor.authorJohnson, Pen
dc.contributor.authorMeyer, Ren
dc.contributor.authorRadford, John Aen
dc.contributor.authorRaemaekers, Jen
dc.contributor.authorHodgson, Den
dc.contributor.authorEvens, Aen
dc.date.accessioned2018-06-04T09:48:45Z-
dc.date.available2018-06-04T09:48:45Z-
dc.date.issued2018-04-29-
dc.identifier.citationEarly-stage Hodgkin lymphoma in the modern era: simulation modelling to delineate long-term patient outcomes. 2018 Br J Haematolen
dc.identifier.issn1365-2141-
dc.identifier.pmid29707774-
dc.identifier.doi10.1111/bjh.15255-
dc.identifier.urihttp://hdl.handle.net/10541/621031-
dc.descriptionLymphoma Research Teamen
dc.description.abstractWe 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) via 18 F-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.en
dc.language.isoenen
dc.rightsArchived with thanks to British journal of haematologyen
dc.titleEarly-stage Hodgkin lymphoma in the modern era: simulation modelling to delineate long-term patient outcomes.en
dc.typeArticleen
dc.contributor.departmentDepartment of Pediatrics, Tufts University School of Medicine, Boston, MA, USAen
dc.identifier.journalBritish Journal of Haematologyen

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