{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T08:43:19Z","timestamp":1782808999559,"version":"3.54.5"},"reference-count":21,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"11","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncology Practice"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec><jats:title>PURPOSE:<\/jats:title><jats:p> Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy. Five-year survival is approaching 90%. In efforts to further improve outcomes, it is critical to consider the cost of ALL care. <\/jats:p><\/jats:sec><jats:sec><jats:title>MATERIALS AND METHODS:<\/jats:title><jats:p> Commercial insurance data from OptumLabs Data Warehouse were used to identify patients with ALL, age 1-30 years, diagnosed in 1993-2017 in the United States, with 36 months of continuous insurance coverage. Patients treated with hematopoietic cell transplantation were excluded. Inpatient and outpatient utilization and cumulative reimbursements (inflation-adjusted to December 2020) were computed 8 and 36 months from diagnosis and stratified by age (1-9, 10-12, and \u2265 13 years) as proxies for National Cancer Institute risk groups. Regression models were constructed to assess associations with demographic and clinical characteristics. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p> Among 927 patients (median age, 6 years; interquartile range, 3-12 years; 43% female), individuals age \u2265 10 years had 23-25 more inpatient days and 22 more outpatient encounters compared with younger patients. The 36-month median cost was $394,000 (USD) (interquartile range, $256,000-$695,000 [USD]), and 64% of the total cost was incurred during the initial 8 months. The 36-month cost was 1.5-fold higher for those age 10-12 years and 1.7-fold higher for those age \u2265 13 years compared with 1-9 years. The cost for those diagnosed in 2013-2017 was 70% higher compared with 1993-2002, and was not different on the basis of sex, race, or ethnicity. <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION:<\/jats:title><jats:p> Older age was associated with higher utilization and cost, and the cost of treatment increased significantly over time. These data provide valuable benchmarks for future studies examining the cost-benefit of ALL therapy modifications. <\/jats:p><\/jats:sec>","DOI":"10.1200\/op.22.00344","type":"journal-article","created":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T19:59:11Z","timestamp":1664308751000},"page":"e1750-e1761","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":8,"title":["Real-World Cost of Pediatric Acute Lymphoblastic Leukemia Care Among Commercially Insured Individuals in the United States: Effect of Era and Age at Diagnosis"],"prefix":"10.1200","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4106-6172","authenticated-orcid":false,"given":"Lucie M.","family":"Turcotte","sequence":"first","affiliation":[{"name":"University of Minnesota Medical School, Minneapolis, 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