{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T22:20:23Z","timestamp":1778278823557,"version":"3.51.4"},"reference-count":24,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"4","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncol Pract"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p> BMT CTN 1102 was a phase III trial comparing reduced-intensity allogeneic hematopoietic cell transplantation (RIC alloHCT) to standard of care for persons with intermediate- or high-risk myelodysplastic syndrome (MDS). We report results of a cost-effectiveness analysis conducted alongside the clinical trial. <\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p> Three hundred eighty-four patients received HCT (n = 260) or standard of care (n = 124) according to availability of a human leukocyte antigen\u2013matched donor. Cost-effectiveness was calculated from US commercial and Medicare perspectives over a 20-year time horizon. Health care utilization and costs were estimated using propensity score\u2013matched cohorts of HCT recipients in the OptumLabs Data Warehouse (age 50-64 years) and Medicare (age 65 years and older). EuroQol 5 Dimension (EQ-5D) surveys of trial participants were used to derive health state utilities. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> Extrapolated 20-year overall survival for those age 50-64 years was 29% for HCT (n = 105) versus 13% for usual care (n = 44) and 31% for HCT (n = 155) versus 12% for non-HCT (n = 80) for those age 65 years and older. HCT was more effective (+2.36 quality-adjusted life-years [QALYs] for age 50-64 years and +2.92 QALYs for age 65 years and older) and more costly (+$452,242 in US dollars (USD) for age 50-64 years and +$233,214 USD for age 65 years and older) than usual care, with incremental cost-effectiveness ratios of $191,487 (USD)\/QALY and $79,834 (USD)\/QALY, respectively. For persons age 50-64 years, there was a 29% chance that HCT was cost-effective using a willingness-to-pay (WTP) threshold of $150K (USD)\/QALY and 51% at a $200K (USD)\/QALY. For persons age 65 years and older, the probability was 100% at a WTP &gt;$150K (USD)\/QALY. <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p> Among patients age 65 years and older with high-risk MDS, RIC HCT is a high-value strategy. For those age 50-64 years, HCT is a lower-value strategy but has similar cost-effectiveness to other therapies commonly used in oncology. <\/jats:p><\/jats:sec>","DOI":"10.1200\/op.23.00413","type":"journal-article","created":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T21:00:31Z","timestamp":1706043631000},"page":"572-580","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":10,"title":["Cost-Effectiveness of Reduced-Intensity Allogeneic Hematopoietic Cell Transplantation for Older Patients With High-Risk Myelodysplastic Syndrome: Analysis of BMT CTN 1102"],"prefix":"10.1200","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6544-5815","authenticated-orcid":true,"given":"Wael","family":"Saber","sequence":"first","affiliation":[{"name":"Medical College of Wisconsin, Milwaukee, WI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5507-2640","authenticated-orcid":true,"given":"Aasthaa","family":"Bansal","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center, Seattle, WA"},{"name":"University of Washington, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4026-5682","authenticated-orcid":true,"given":"Lily","family":"Li","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9620-7839","authenticated-orcid":true,"given":"Bart L.","family":"Scott","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsey R.","family":"Sangaralingham","sequence":"additional","affiliation":[{"name":"Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN"},{"name":"Department of Health Sciences Research, Division of Health Care Policy and Research (X.Y., N.D.S.), Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viengneesee","family":"Thao","sequence":"additional","affiliation":[{"name":"Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN"},{"name":"Department of Health Sciences Research, Division of Health Care Policy and Research (X.Y., N.D.S.), Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6621-8342","authenticated-orcid":true,"given":"Joshua A.","family":"Roth","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle, WA"},{"name":"Pfizer Inc, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6811-750X","authenticated-orcid":true,"given":"Winona","family":"Wright","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lotte M.G.","family":"Steuten","sequence":"additional","affiliation":[{"name":"Office of Health Economics, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph A.","family":"Pidala","sequence":"additional","affiliation":[{"name":"Moffitt Cancer Center, Tampa, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3065-4294","authenticated-orcid":true,"given":"Asmita","family":"Mishra","sequence":"additional","affiliation":[{"name":"Moffitt Cancer Center, Tampa, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8184-7099","authenticated-orcid":true,"given":"Richard T","family":"Maziarz","sequence":"additional","affiliation":[{"name":"Knight Cancer Institute, Oregon Health & Science University, Portland, OR"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Westervelt","sequence":"additional","affiliation":[{"name":"Washington University, St Louis, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0539-4796","authenticated-orcid":true,"given":"Joseph P.","family":"McGuirk","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center, Kansas City, KS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8728-4314","authenticated-orcid":true,"given":"Corey","family":"Cutler","sequence":"additional","affiliation":[{"name":"Dana Farber Cancer Institute, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryotaro","family":"Nakamura","sequence":"additional","affiliation":[{"name":"City of Hope National Medical Center, Duarte, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5972-8280","authenticated-orcid":true,"given":"Scott D.","family":"Ramsey","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center, Seattle, WA"},{"name":"University of Washington, Seattle, WA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"b1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.03380"},{"key":"b2","volume-title":"Allogeneic Hematopoietic Stem Cell Transplant for MDS","author":"Centers for Medicare &amp; Medicaid Services","year":"2023"},{"key":"b3","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26768"},{"key":"b4","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V89.6.2079"},{"key":"b5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2005.00045.x"},{"key":"b6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.1792"},{"key":"b11","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2014.0038"},{"key":"b12","volume-title":"Consumer Price Index: Chained Consumer Price Index for All Consumers (C-CPI-U)","author":"Bureau of Labor Statistics","year":"2017"},{"key":"b13","doi-asserted-by":"publisher","DOI":"10.2307\/2533947"},{"key":"b14","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-6296(98)00056-3"},{"key":"b15","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.publhealth.23.100901.140534"},{"key":"b17","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2022008097"},{"key":"b18","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2022-171463"},{"key":"b19","doi-asserted-by":"publisher","DOI":"10.1136\/medethics-2014-102386"},{"key":"b20","volume-title":"Summarizing Population Health: Directions for the Development and Application of Population Metrics","author":"Institute of Medicine (US) Committee on Summary Measures of Population Health","year":"1998"},{"key":"b21","doi-asserted-by":"publisher","DOI":"10.1186\/s40425-018-0442-7"},{"key":"b22","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2015.37"},{"key":"b23","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.02724"},{"key":"b24","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2019.5140"},{"key":"b25","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020001719"},{"key":"b26","volume-title":"Mutation Analysis in Patients With High-Risk Myelodysplastic Syndrome Receiving Allogeneic Hematopoietic Cell Transplantation Based on Biological Donor Availability: Blood and Marrow Transplant Clinical Trials Network (BMT CTN) Study 1102","author":"Versluis J","year":"2022"},{"key":"b27","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dju002"},{"key":"b28","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-04-422204"},{"key":"b29","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.35.8135"}],"container-title":["JCO Oncology Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/OP.23.00413","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T22:01:08Z","timestamp":1712786468000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/OP.23.00413"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":24,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1200\/OP.23.00413"],"URL":"https:\/\/doi.org\/10.1200\/op.23.00413","relation":{},"ISSN":["2688-1527","2688-1535"],"issn-type":[{"value":"2688-1527","type":"print"},{"value":"2688-1535","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]},"assertion":[{"value":"2023-07-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-07","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}