QUALITY
OF LIFE AND COST ANALYSIS OF AMIFOSTINE CYTOPROTECTION IN CHILDREN TREATED
FOR CANCER
Stolarska M, Mlynarski W,
Kowalewska-Pietrzak M, Bodalski J
Clinic of Paediatrics, Medical
University of Łodz, Poland
Objective: To estimate early toxicity of chemotherapy
and supportive therapy costs in children treated for cancer with (group A)
or without (group C)
amifostine cytoprotection.
Methods: A retrospective not randomized analysis of 57 chemotherapy courses
in 18 children was performed. Amifostine (Ethyol, Schering-Plough, USA) was administered in 18 courses.
Early toxicity was estimated according to WHO criteria and hospitalization
time, neutropenia duration, infectious complications, number of blood
products transfusions and G-CSF administration. Only direct medical costs
were measured, including i.v.
antibiotics, immunoglobulin, blood products, administration of G-CSF and
total hospitalization cost.
Results: Mean myelotoxicity
stage was lower in the group A compared with group C (2.54±0.69 v. 2.71±0.22). Mean number of
RBC transfusions amounted to 0.8±0.24 in group A and 1.1±0.27 in group C.
Neutropenia lasted 6.5±2.5 days in group A and
5.7±0.7 days in group C.
Severe infectious events were found more often in group C (1.02±0.17) comparing to the
group A (0.72±0.27; p=0.043). Children from group A
needed shortened administration of intravenous antibiotics (4.5±1.5 days v. 7.3±1.2 days; p=0.036).
Total hospitalization cost in the group A (1750.0±311.5 $) differed
significantly from group C (2244.2±253.2 $; amifostine
cost was excluded). Moreover, the cost of i.v. antibiotics was lower in group A v. C (224.0±57.6 $ v. 608.3±19.5 $, respectively; p=0.037)
Conclusion:
Amifostine support during anticancer chemotherapy in children decreases
number of severe infectious events, which involves also reduction of
antibiotics cost followed by lower hospitalization cost.
Supported by AM Nr
502-11-583 grant