Cost-effectiveness of limited screening panel for acute lymphoblastic leukemia diagnosis in a resource-limited setting
https://doi.org/10.21141/PJP.2021.04
- Author:
Ivy Mae Medalla
1
;
Maria Beatriz Gepte
1
;
Qareem Pido
1
;
Daphne Ang
1
Author Information
1. Division of Pathology, Philippine Childrens Medical Center
- Publication Type:Journal Article
- Keywords:
Limited screening panel;
Pediatric population;
Filipino
- MeSH:
Precursor Cell Lymphoblastic Leukemia-Lymphoma
- From:
Philippine Journal of Pathology
2021;6(1):26-30
- CountryPhilippines
- Language:English
-
Abstract:
Background:Flow cytometry is an invaluable tool in the diagnostic evaluation of acute leukemia and post therapy monitoring; however, majority of Filipino population cannot afford the cost. The use of a minimal screening panel which is both cost-effective and provides an accurate diagnosis of acute lymphoblastic leukemia is seen as an alternative.
Objectives:We aim to determine the cost-effectiveness and accuracy of using a minimal screening panel for the diagnosis of acute lymphoblastic leukemia (ALL).
Methodology:We selected a limited panel of 9 antibodies comprising of CD45/CD19/CD20/CD10/HLA-DR/CD34/cCD3/cCD79a/cTdt and retrospectively reviewed newly diagnosed cases of B-cell and T-cell ALL from September 2016 to December 2019 using this panel.
Results:Out of 719 bone marrow aspirates submitted for basic leukemia flow cytometric analysis we identified 268 ALL cases (239 B-ALL and 29 T-ALL). In all cases, a diagnosis was established using the limited panel. Compared to the current cost of our comprehensive panel (₱ 9,903.60). This limited panel cost ₱ 3,062.29, that offers a 69.08% savings per test, which translated to a ₱1.2 million savings a year (for an average of 180 annual cases).
Conclusion:We underscore the utility of a limited panel for the diagnosis of ALL. Although this panel remains to be assessed with a larger validation cohort, its application in resource-limited developing countries is diagnostically useful and cost-effective.
Recommendation:The use of a limited panel of 9 antibodies is recommended as a screening panel for patients who are highly suspected of having ALL both clinically and initial bone marrow smear assessment.
- Full text:31 pjp.pdf
