Early-stage Hodgkin lymphoma in the modern era: simulation modelling to delineate long-term patient outcomes.
Radford, John A
AffiliationDepartment of Pediatrics, Tufts University School of Medicine, Boston, MA, USA
MetadataShow full item record
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.
CitationEarly-stage Hodgkin lymphoma in the modern era: simulation modelling to delineate long-term patient outcomes. 2018 Br J Haematol
JournalBritish Journal of Haematology
DescriptionLymphoma Research Team
- Positron emission tomography-adapted therapy for first-line treatment in individuals with Hodgkin lymphoma.
- Authors: Sickinger MT, von Tresckow B, Kobe C, Engert A, Borchmann P, Skoetz N
- Issue date: 2015 Jan 9
- Chemotherapy or Combined Modality Therapy for Early-stage Hodgkin Lymphoma.
- Authors: Torok JA, Wu Y, Chino J, Prosnitz LR, Beaven AW, Kim GJ, Kelsey CR
- Issue date: 2018 May
- Management of nodular lymphocyte predominant Hodgkin lymphoma in the modern era.
- Authors: King MT, Donaldson SS, Link MP, Natkunam Y, Advani RH, Hoppe RT
- Issue date: 2015 May 1
- Hodgkin Lymphoma: the Changing Role of Radiation Therapy in Early-Stage Disease—the Role of Functional Imaging.
- Authors: Iberri DJ, Hoppe RT, Advani RH
- Issue date: 2015 Sep
- Combined modality therapy versus chemotherapy alone as an induction regimen for primary central nervous system lymphoma: a cost-effectiveness analysis.
- Authors: Prica A, Chan K, Cheung M
- Issue date: 2014 Oct