Health care utilisation and costs associated with different treatment protocols for newly diagnosed childhood acute lymphoblastic leukaemia: A population-based study in Ontario, Canada

2021 ◽  
Vol 151 ◽  
pp. 126-135
Author(s):  
Sumit Gupta ◽  
Rinku Sutradhar ◽  
Qing Li ◽  
Uma Athale ◽  
Myele Bassal ◽  
...  
Keyword(s):  
Health Care ◽  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Population Based ◽  
Health Care Utilisation ◽  
Newly Diagnosed ◽  
Population Based Study ◽  
Treatment Protocols ◽  
Childhood Acute Lymphoblastic Leukaemia ◽  
Care Utilisation

scholarly journals Health care utilisation preceding relapse or second malignant neoplasm after childhood acute lymphoblastic leukaemia: a population-based matched cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e050285
Author(s):  
Karen Schow Jensen ◽  
Birgitte Klug Albertsen ◽  
Henrik Schrøder ◽  
Alina Zalounina Falborg ◽  
Kjeld Schmiegelow ◽  
...  
Keyword(s):  
Health Care ◽  
General Practice ◽  
Malignant Neoplasm ◽  
Population Based ◽  
Health Care Utilisation ◽  
Second Malignant Neoplasm ◽  
Childhood All ◽  
Bimodal Structure ◽  
Childhood Acute Lymphoblastic Leukaemia ◽  
Care Utilisation

ObjectivesTo investigate health care utilisation including both primary and secondary health care 6 months before the diagnosis of a relapse or a second malignant neoplasm (SMN) in survivors of childhood acute lymphoblastic leukaemia (ALL).Design and settingA Danish population-based matched cohort study linking multiple nationwide registries.ParticipantsParticipants were recruited from a total of 622 childhood ALL 2.5-year event-free survivors diagnosed between 1994 and 2015. Cases were survivors developing a relapse or an SMN and references were survivors still in first remission. Each case was matched with five references on age, sex, treatment protocol and risk group.Primary outcome measuresConsultations in general practice and hospital the last 6 months before relapse or SMN. Cases and references were compared with monthly incidence rate ratios (IRRs) from negative binomial regression models.ResultsOf the 622 childhood ALL survivors, 60 (9.6%) developed a relapse (49) or an SMN (11) and 295 matched references were identified. Health care utilisation in general practice increased among cases the last month before the event compared with references with an IRR of 2.71 (95% CI 1.71 to 4.28). Data showed a bimodal structure with a significantly increased number of visits 4, 5 and 6 months before the event. Hospital health care utilisation increased 2 months before the event in cases with an IRR of 5.01 (3.78 to 6.63) the last month before the event and an IRR of 1.94 (1.32 to 2.85) the second-last month comparing cases and references.ConclusionsSurvivors of childhood ALL developing a relapse or an SMN have a short period of increased health care utilisation before diagnosis. At hospital, this might be explained by pre-diagnostic examinations. In general practice, data suggest a bimodal structure with children later developing a relapse having more contacts also half a year before the relapse, suggesting that there could be early warnings.

scholarly journals The Impact of Population-Based Disease Management Services on Health Care Utilisation and Costs: Results of the CAPICHe Trial

2018 ◽  
Vol 34 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Paul A. Scuffham ◽  
Joshua M. Byrnes ◽  
Christine Pollicino ◽  
David Cross ◽  
Stan Goldstein ◽  
...  
Keyword(s):  
Health Care ◽  
Disease Management ◽  
Population Based ◽  
Health Care Utilisation ◽  
Care Utilisation ◽  
The Impact ◽  
Management Services

scholarly journals Orbital Swelling and Ptosis as an Initial Presentation of Childhood Acute Lymphoblastic Leukaemia: A Case Report and Review of the Literature

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Ahmed Alsalem ◽  
Bayan Almasoudi ◽  
Ghaida Alzahrani ◽  
Lama Sindi ◽  
Joud Alwan
Keyword(s):  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Bone Marrow Examination ◽  
Review Of The Literature ◽  
Lymphoid Leukaemia ◽  
Management Options ◽  
Treatment Protocols ◽  
Childhood Acute Lymphoblastic Leukaemia ◽  
Eyelid Swelling ◽  
Assessment And Treatment

We are reporting the case of a 3-year-old-girl who initially presented with unilateral eyelid swelling and ptosis. A diagnosis of acute lymphoblastic leukaemia (ALL) was eventually made based on an orbital incisional biopsy and a bone marrow examination. Historically, orbital involvement had been linked to myeloid leukaemia; however, in lymphoid leukaemia, they are increasingly being implicated and had been reported as the sole presentation of the disease. These findings stress the importance of conducting ophthalmologic assessments in cases diagnosed with ALL in order to prevent delays in proper assessment and treatment. Management options in orbital disease are fortunately not significantly different than well-established treatment protocols.

Clinical Implications of Methotrexate Pharmacogenetics in Childhood Acute Lymphoblastic Leukaemia

2019 ◽  
Vol 20 (4) ◽  
pp. 313-330 ◽  
Author(s):  
Guillermo Gervasini ◽  
Sonia Mota-Zamorano
Keyword(s):  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Current Knowledge ◽  
Research Literature ◽  
Bibliographic Databases ◽  
Treatment Protocols ◽  
Childhood Acute Lymphoblastic Leukaemia ◽  
Significant Research ◽  
Review Question ◽  
High Doses

Background:In the past two decades, a great body of research has been published regarding the effects of genetic polymorphisms on methotrexate (MTX)-induced toxicity and efficacy. Of particular interest is the role of this compound in childhood acute lymphoblastic leukaemia (ALL), where it is a pivotal drug in the different treatment protocols, both at low and high doses. MTX acts on a variety of target enzymes in the folates cycle, as well as being transported out and into of the cell by several transmembrane proteins.Methods:We undertook a structured search of bibliographic databases for peer-reviewed research literature using a focused review question.Results:This review has intended to summarize the current knowledge concerning the clinical impact of polymorphisms in enzymes and transporters involved in MTX disposition and mechanism of action on paediatric patients with ALL.Conclusion:In this work, we describe why, in spite of the significant research efforts, pharmacogenetics findings in this setting have not yet found their way into routine clinical practice.

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