{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T15:45:41Z","timestamp":1757778341825,"version":"3.41.2"},"reference-count":40,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,8,10]],"date-time":"2024-08-10T00:00:00Z","timestamp":1723248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Childhood cancers are a significant global health concern, particularly in low\u2010 and middle\u2010income countries (LMICs), where over 80% of childhood cancer patients reside. In India, acute myeloid leukemia (AML) constitutes a significant portion of childhood cancers; however, the data on the cost\u2010effectiveness of childhood AML treatment in India and other LMICs remain limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study focused on children (&lt;15\u00a0years of age) diagnosed with AML at a tertiary care cancer center in North India. Data, including treatment outcome, treatment\u2010related morbidity, mortality, and costs were retrospectively collected from the electronic medical record and hospital database. Cost\u2010effectiveness was assessed using disability\u2010adjusted life years (DALY) averted in relation to the country\u2010specific cost\u2010effectiveness threshold.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 59 AML patients, treatment\u2010related high mortality rates, abandonment, and limited access to bone marrow transplantation were notable challenges. Intensive chemotherapy resulted in substantial sepsis\u2010related complications, with treatment\u2010related mortality reaching 30%. The 3\u2010year event\u2010free survival and overall survival of the 43 patients who received intensive therapy were 24.5%\u00a0\u00b1\u00a07.6% and 27.9%\u00a0\u00b1\u00a08.3%, respectively. Despite these challenges, treating childhood AML was still found to be cost\u2010effective. The total cost per newly diagnosed patient treated with curative intent was $4454. Cost per DALY averted accounted for 24% of the gross domestic product (GDP) per capita, rendering the treatment to be cost\u2010effective with a stringent cost\u2010effectiveness threshold utilized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The study underscores the challenges faced while treating childhood AML in LMICs, including treatment\u2010induced high sepsis\u2010related mortality and abandonment. Despite these challenges, it remains cost\u2010effective to treat childhood AML in India. Future efforts should focus on reducing treatment\u2010related morbidity and mortality to further improve outcomes and cost\u2010effectiveness.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31242","type":"journal-article","created":{"date-parts":[[2024,8,10]],"date-time":"2024-08-10T11:58:04Z","timestamp":1723291084000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Cost\u2010effectiveness of treating childhood acute myeloid leukemia at a tertiary care center in North India"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2587-9181","authenticated-orcid":false,"given":"Shyam","family":"Srinivasan","sequence":"first","affiliation":[{"name":"Department of Pediatric Oncology, Tata Memorial Hospital and ACTREC, Tata Memorial Centre Homi Bhabha National Institute  Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy S.","family":"Bolous","sequence":"additional","affiliation":[{"name":"Department of Global Pediatric Medicine St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akshay","family":"Batra","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine, Homi Bhabha Cancer Hospital and Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Tata Memorial Centre Homi Bhabha National Institute  Varanasi Uttar Pradesh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sujit","family":"Bharti","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Homi Bhabha Cancer Hospital and Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Tata Memorial Centre Homi Bhabha National Institute  Varanasi Uttar Pradesh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neha","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Hematopathology, Homi Bhabha Cancer Hospital and Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Tata Memorial Centre Homi Bhabha National Institute  Varanasi Uttar Pradesh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanveer","family":"Shaikh","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Homi Bhabha Cancer Hospital and Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Tata Memorial Centre Homi Bhabha National Institute  Varanasi Uttar Pradesh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anil","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Cytogenetics, Homi Bhabha Cancer Hospital and Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Tata Memorial Centre Homi Bhabha National Institute  Varanasi Uttar Pradesh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikramjit","family":"Kanwar","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Homi Bhabha Cancer Hospital and Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Tata Memorial Centre Homi Bhabha National Institute  Varanasi Uttar Pradesh India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,8,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(19)30339-0"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh\u20102019\u2010001825"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13312-021-2210-x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/2278-330X.187591"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/08880018.2010.531521"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1754370"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737140.2021.1895756"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.30791"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciq147"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03570.x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31022"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/jgo.17.00243"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.33280"},{"key":"e_1_2_10_15_1","unstructured":"World development indicators: exchange rates and prices.World Bank Group. Accessed November 14 2023.https:\/\/wdi.worldbank.org\/table\/4.16"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101729"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(23)00162-6"},{"key":"e_1_2_10_18_1","unstructured":"India life expectancy: World Bank Group. Accessed November 14 2023.https:\/\/data.worldbank.org\/country\/india"},{"issue":"3","key":"e_1_2_10_19_1","first-page":"495","article-title":"The global burden of disease in 1990: summary results, sensitivity analysis and future directions","volume":"72","author":"Murray CJ","year":"1994","journal-title":"Bull World Heal Organ"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djw046"},{"key":"e_1_2_10_21_1","unstructured":"GDP per capita (current US$) \u2010 India.World Bank Group. Accessed November 14 2023.https:\/\/data.worldbank.org\/indicator\/NY.GDP.PCAP.CD?locations=IN"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.30175"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(23)00053-0"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.34728"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1200\/GO.20.00240"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phoj.2023.01.005"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.4103\/oji.oji_23_20"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-022-00726-1"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.28087"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000002876"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.4103\/CRST.CRST_50_20"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/2040620720913010"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.4103\/ajts.ajts_29_21"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2023.70012"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V128.22.5938.5938"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/1478-7547-1-8"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.5140"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)70117-2"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/cnr2.1359"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.4103\/0973-1075.150192"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27716"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.31242","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T13:52:30Z","timestamp":1748353950000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.31242"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,10]]},"references-count":40,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1002\/pbc.31242"],"URL":"https:\/\/doi.org\/10.1002\/pbc.31242","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"type":"print","value":"1545-5009"},{"type":"electronic","value":"1545-5017"}],"subject":[],"published":{"date-parts":[[2024,8,10]]},"assertion":[{"value":"2023-12-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e31242"}}