Improvement in the results of treatment of selected blood diseases and changes in the costs of such treatment. Issues for economists and other experts

Czech version

Authors: Z. Adam ¹; J. Vorlíček ¹; Z. Kořístek ¹; Z. Adamová ²
Authors‘ workplace: Interní hematoonkologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jiří Vorlíček, CSc. ¹; Zdravotní středisko pro děti a dorost, Brno, Obilní trh 9, vedoucí MUDr. Zdenka Adamová ²
Published in: Vnitř Lék 2007; 53(6): 735-749
Category: Forum

Overview

The text maps the changes in treatment results and costs for three haematological diseases; multiple myeloma; diffuse large B-cell lymphoma and chronic myeloid leukaemia. At the beginning of the 1990’s, the alkeran – prednisone combination was the golden standard in the treatment of myeloma. In the mid 1990’s, the treatment results in younger patients were dramatically improved by high-dose chemotherapy with autologous transplantation. The first decade of the new millennium has brought about even better results after the introduction of thalidomide in the initial treatment in patients not indicated for transplantation. Improvement is also expected in patients of a younger age group thanks to the combination of new drugs with autologous transplantation. A breakthrough in the treatment of patients with diffuse large cell lymphoma was the introduction in the treatment regimen of high-dose chemotherapy with autologous transplantation, and primarily the introduction of a new drug – a monoclonal antibody antiCD20, rituximab, in initial treatment. The golden standard for patients with chronic leukaemia in the early 1990’s was hydroxyurea treatment. This was replaced by a new golden standard – interferon α, which was, in turn, replaced by the specific blocker of bcr-abl thyrosine kinase – imatinib. The text contains tables and charts showing the therapeutic benefit of the options mentioned above and the related costs.

Key words:
multiple myeloma – malignant lymphoma – chronic myeloid leukaemia

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