The Impact of Hematopoietic Stem Cell Transplantation on Work and Productivity Loss in Patients with Acute Leukemia – Results from a Rapid Review
This year, the 46th annual meeting for the European Group for Blood and Marrow Transplant (EBMT) has gone virtual! Medlior presented its evidence synthesis poster on the impact of work and productivity loss due to treatment in patients with acute leukemia in partnership with Pfizer Inc. You can view the full poster here.
Acute myeloid leukemia (AML) and acute lymphocytic leukemia (ALL) are hematological cancers that are both characterized by rapid onset. Treatment for AML and ALL generally consists of upfront chemotherapy with the goal of achieving a complete remission (CR). Following CR, patients can be considered for hematopoietic stem cell transplant therapy (HSCT).
A recent study on the economic burden of malignant blood disorders in Europe estimated that the total cost to 31 European countries was €12 billion in 2012, with an estimated €3.6 billion in productivity losses.1 However, the lost work productivity due to hematological cancers, specifically AML/ALL, is not well explored. Understanding the effect of ALL/AML and associated treatment with HSCT on the work productivity of adult patients with ALL or AML represents a tangible measure of the societal burden of disease and is a key consideration in health policy.
To fill this knowledge gap, a rapid review was conducted to identify published real-world evidence examining work productivity loss associated with hematological cancers, including those who received HSCT. There were seven included studies that examined patients with hematological cancer and six studies that examined patients who underwent HSCT. All studies reported varied return-to-work outcomes, ranging from income, workability, and disability pension amongst others.
Of the seven studies that assessed the impact of hematological cancer, four reported decreased employment among patients as compared to the general population, while three studies observed positive return-to-work outcomes. Of the six studies examined patients undergoing stem cell therapy, five found a general trend towards decreased employment and increased low-income status, although two studies reported improved back-to-work outcomes over time. There were two studies in adult survivors of childhood hematological cancers that found the opposite results in unemployment as an outcome.
The results of this evidence synthesis show a limited amount of evidence related to work productivity in patients with hematological cancer, including patients who received HSCT. This rapid review suggests the need for future research involving a direct comparison of patients with and without HSCT, and a better understanding of causes of unemployment post-HSCT, along with the exploration of systematic changes in healthcare delivery systems for better patient rehabilitation.
To learn more about this research, view the full poster here.
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- Burns R, Leal J, Sullivan R, Luengo-Fernandez R. Economic burden of malignant blood disorders across Europe: a population-based cost analysis. The Lancet Haematology 2016; 3(8): e362-70.