RESUMO
BACKGROUND AND OBJECTIVE: The cost of treating cutaneous T-cell lymphoma (CTCL) in Spain is unknown. With the advent of new treatments, it is more important than ever to gain an accurate picture of the true costs involved. The MICADOS study had 2 primary objectives: 1)to evaluate the impact of CTCL on patient quality of life, and 2)to evaluate the costs associated with the disease. This article reports the results of the cost analysis. METHODS: We estimated the cost of treating CTCL over a period of 1year from the perspective of the Spanish National Health System. Twenty-three dermatologists and hematologists from 15 public hospitals analyzed data for adult patients with mycosis fungoides (MF) or Sézary syndrome (SS). RESULTS: A total of 141 patients (57.4% male) with a mean age of 63.6 years (95%CI: 61.4-65.7 years) were included. The mean direct annual cost of treating CTCL was 34,214 per patient. The corresponding costs by stage were 11,952.47 for stageI disease, 23,506.21 for stageII disease, 38,771.81 for stageIII disease, and 72,748.84 for stageIV disease. The total direct annual cost of treating MF/SS in public hospitals in Spain was estimated at 78,301,171; stageI disease accounted for 81% of all costs, stageII for 7%, and stagesIII andIV for 6% each. CONCLUSIONS: The MICADOS study offers an accurate picture of the direct cost of treating CTCL in patients with MF/SS in Spain and shows that costs vary significantly according to disease stage. Patient-borne and indirect costs should be analyzed in future studies.
Assuntos
Linfoma Cutâneo de Células T , Micose Fungoide , Síndrome de Sézary , Neoplasias Cutâneas , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Qualidade de Vida , Espanha/epidemiologia , Neoplasias Cutâneas/terapia , Neoplasias Cutâneas/patologia , Linfoma Cutâneo de Células T/epidemiologia , Linfoma Cutâneo de Células T/terapia , Linfoma Cutâneo de Células T/patologia , Micose Fungoide/terapia , Micose Fungoide/patologia , Síndrome de Sézary/terapia , Síndrome de Sézary/patologiaRESUMO
BACKGROUND AND OBJECTIVE: The cost of treating cutaneous T-cell lymphoma (CTCL) in Spain is unknown. With the advent of new treatments, it is more important than ever to gain an accurate picture of the true costs involved. The MICADOS study had 2 primary objectives: 1)to evaluate the impact of CTCL on patient quality of life, and 2)to evaluate the costs associated with the disease. This article reports the results of the cost analysis. METHODS: We estimated the cost of treating CTCL over a period of 1year from the perspective of the Spanish National Health System. Twenty-three dermatologists and hematologists from 15 public hospitals analyzed data for adult patients with mycosis fungoides (MF) or Sézary syndrome (SS). RESULTS: A total of 141 patients (57.4% male) with a mean age of 63.6 years (95%CI: 61.4-65.7 years) were included. The mean direct annual cost of treating CTCL was 34,214 per patient. The corresponding costs by stage were 11,952.47 for stageI disease, 23,506.21 for stageII disease, 38,771.81 for stageIII disease, and 72,748.84 for stageIV disease. The total direct annual cost of treating MF/SS in public hospitals in Spain was estimated at 78,301,171; stageI disease accounted for 81% of all costs, stageII for 7%, and stagesIII andIV for 6% each. CONCLUSIONS: The MICADOS study offers an accurate picture of the direct cost of treating CTCL in patients with MF/SS in Spain and shows that costs vary significantly according to disease stage. Patient-borne and indirect costs should be analyzed in future studies.
Assuntos
Linfoma Cutâneo de Células T , Micose Fungoide , Síndrome de Sézary , Neoplasias Cutâneas , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Qualidade de Vida , Espanha/epidemiologia , Neoplasias Cutâneas/terapia , Neoplasias Cutâneas/patologia , Linfoma Cutâneo de Células T/terapia , Linfoma Cutâneo de Células T/patologia , Micose Fungoide/terapia , Micose Fungoide/patologia , Síndrome de Sézary/terapia , Síndrome de Sézary/patologiaRESUMO
Primary cutaneous lymphomas (PCLs) are a heterogeneous group of lymphoid tumors that originate primarily in the skin. Most PCLs (75%) are T-cell lymphomas and only 20% to 25% involve B cells. It is important to differentiate between cutaneous lymphomas and lymph node tumors given the differences in their molecular biology and clinical, histopathologic, and immunophenotypic features. Moreover, PCLs generally follow a more indolent course and require different treatments. Many treatment options are available for managing PLC's. The choice should be based primarily on the clinical stage of disease but must also take into consideration other factors, such as the patient's age and general health, the availability and accessibility of the treatment, and the cost-benefit ratio. It will be important to use a multidisciplinary approach, involving a team of expert dermatologists, hematologist-oncologists, and radiotherapists who are familiar with this rare disease. Recent years have seen the emergence of many new therapies, particularly for advanced stages of the disease and for patients whose tumors have proven refractory to treatment. The objective of this article is to review all the treatment options available to us.
Assuntos
Linfoma de Células B/terapia , Linfoma Cutâneo de Células T/terapia , Neoplasias Cutâneas/terapia , HumanosRESUMO
This article reviews the history of cutaneous lymphomas through the articles published on this subject in the journal Actas Dermo-Sifiliográficas. Approximately 100 years after Alibert published the first description of a patient with mycosis fungoides in 1806, reports of cutaneous lymphoma cases began to appear in Actas. These articles reflect how the definition, classification, and treatment of this disease, which continues to pose a challenge for dermatology, have evolved over the 100-year lifespan of the journal.