Minimal residual disease evaluation in childhood acute lymphoblastic leukemia

These analyses are then presented to the Ontario Health Technology Advisory Committee, whose mandate is to examine proposed health technologies in the context of available evidence and existing clinical practice and to provide advice and recommendations to Ontario health care practitioners, the broader health care system, and the Ontario Ministry of Health and Long-Term Care. [...] It was decided a priori to use two different checklists to evaluate methodologic quality of the eligible economic studies: the Consensus on Health Economic Criteria for patient-level economic analyses, and the British Medical Journal Checklist for model-based economic analyses.22,23 In addition, the applicability of the studies to the topic and Ontario’s context was assessed using Section 1 of the [...] The results of MRD evaluation were used to assess the risk of relapse and to guide changes in chemotherapy; therefore, treatment intensity was reduced for patients with a low risk of relapse (i.e., low MRD level) and was intensified for patients with a high risk of relapse (i.e., high MRD level). [...] As compared with the medium-risk group of ALL10, the high-risk group of ALL9 included patients at a higher risk of relapse given the presence of unfavourable cytogenetics, of mediastinal enlargement, or of central nervous system or testicular involvement. [...] In terms of differences in phase-specific costs, the highest costs were incurred in the maintenance phase for the medium-risk group using the ALL10 protocol and in the intensification phase using the ALL9 protocol.