Cost analisys of antineoplasic therapy and clinical intercurrences in pediatric acute lymphoblastic leukemia treatment with BFM-2009 protocol

Abstract

Introduction: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy, accounting for 25% of cancers in this age group. Treatment is based on intensive chemotherapy, often associated with clinical complications. Objective: This retrospective study analyzed the treat ment costs of children and adolescents with B-cell lineage ALL from January 2018 to February 2023, treated with the BFM-2009 protocol. Methods: The study population included 34 patients, mostly male. Analyses were conducted by stratifying patients according to risk group (standard, interme diate, and high risk), as defined by the protocol. Cost estimates were obtained using a micro-costing approach, with data collection on hospitalization days, laboratory and non-laboratory tests, hospital devices and medications, medical consultations, surgical procedures, and outpatient chemotherapy sessions. Results: The main complications identified through medical records were anemia, throm bocytopenia and febrile neutropenia. Conclusion: Treatment costs varied according to risk group, with the high-risk group incurring the highest overall and complication-related costs. However, che motherapy costs exceeded those of complications, particularly due to inpatient chemotherapy du ring the consolidation phase. Across all groups, materials and medications represented the largest share of expenses. Despite the high cost of complications, they did not surpass the intrinsic costs of chemotherapy treatment.