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Decision-analytic modeling as a tool for selecting optimal therapy incorporating hematopoietic stem cell transplantation in patients with hematological malignancy

Bone Marrow Transplantation volume 55, pages 1220–1228 (2020)Cite this article

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Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only curative treatment available for various hematological malignancies. Ideally, prospective randomized controlled trials (RCTs) should establish the indications for allo-HSCT. In reality, however, RCTs are not feasible due to the rarity of many hematological conditions. In these scenarios, decision analysis, which simulates possible outcomes with different approaches, can help in selecting the treatment strategy predicted to have the best result. Assessment of cost-effectiveness can also be incorporated in computational simulation analysis. In this review, we would like to provide an overview of decision-analytic models that evaluate alternative treatment strategies for patients with hematological malignancies.

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Fig. 1: Markov-state diagram.
Fig. 2: A simulation analysis assessing the impact of change in the timing of up-front allo-HSCT in patients with aggressive ATL.

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Acknowledgements

This study was supported by Health, Labour, and Welfare Science Grants for Research on Measures for Rare and Intractable Diseases from the Japanese Government.

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Authors and Affiliations

  1. Department of Hematology, Osaka International Cancer Institute, Osaka, Japan

    Shigeo Fuji

  2. Hematology and Bone Marrow Transplantation Division, Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Arnon Nagler & Roni Shouval

  3. Service d’Hématologie clinique, Hopital Saint-Antoine, Sorbonne University, INSERM UMRs 938, Paris, France

    Mohamad Mohty

  4. Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, TN, USA

    Bipin Savani

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Correspondence to Shigeo Fuji.

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Fuji, S., Nagler, A., Mohty, M. et al. Decision-analytic modeling as a tool for selecting optimal therapy incorporating hematopoietic stem cell transplantation in patients with hematological malignancy. Bone Marrow Transplant 55, 1220–1228 (2020). https://doi.org/10.1038/s41409-020-0784-x

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