This is a national, multicenter, ambispective, observational post-authorization study (EPA-SP for its acronym in Spanish) to describe the incidence, clinical management and outcome of aplastic anemia in hospitals throughout Spain.
This is a national, multicenter, ambispective, observational post-authorization study (EPA-SP for its acronym in Spanish) to describe the incidence, clinical management and outcome of aplastic anemia in hospitals throughout Spain. The study includes a retrospective chart review to identify all cases of aplastic anemia diagnosed between January 2010 and the date of the study initiation and a prospective study to detect new cases of aplastic anemia during an 18-month period since the study initiation in the participant hospitals. The study is also designed to collect both retrospective and prospective data on clinical management and outcome of patients with confirmed aplastic anemia. All patients included in the study, including those cases of aplastic anemia identified since 2010 until the study initiation through the retrospective chart review that are alive at the time of inclusion in the study, will be followed up until death or lost-to-follow-up or until 6 months after the last patient is enrolled in the study. The study consists of a baseline visit, follow-up visits every 6 months (± 15 days) until death or lost-to follow-up or up to 6 months after the last patient is enrolled in the study, and a final visit (final/premature withdrawal visit) which will be performed at the study end (6 months after the last patient is enrolled) or in case of premature withdrawal, except for patient withdrawal of consent, loss-to-follow-up or death.
Study Type
OBSERVATIONAL
Enrollment
109
Ambispective chart review
Asociación Instituto Biodonostia
San Sebastián, Guipuzcoa, Spain
To evaluate the incidence of aplastic anemia
The primary endpoint of the study is the number of cases of aplastic anemia per year recorded in the databases of the participant hospitals from January 2010 and the date of the study initiation (retrospective analysis) and all new cases of aplastic anemia detected per year (prospective analysis) during an 18-month period since study initation.
Time frame: 2010-2022
1. Number of patients diagnosed with moderate and severe aplastic anemia.
o The number of patients diagnosed with moderate and severe aplastic anemia will calculated. The number of cases per one million people per year will be presented.
Time frame: 2010-2022
2. Number of patients diagnosed with aplastic anemia according to their age and sex.
The number of males and females diagnosed with aplastic anemia per one million people per year will be calculated. The number of patients diagnosed with aplastic anemia in each age category considered (in the statistical plan) per one million people per year will be calculated.
Time frame: 2010-2022
3. Type of treatment prescribed as first-line, second-line or further-line treatment for aplastic anemia
The percentage of patients receiving each type of treatment for aplastic anemia (stem cell transplantation, immunosuppressive treatment \[ATG + CSA, CSA alone\], androgens, eltrombopag, etc.) for first-line, second and further lines of treatment will be calculated
Time frame: 2010-2022
4. Percentage of responder patients 90, 180, 270 and 360 days after each treatment initiation.
Hematological response will be assessed on the basis of hemoglobin, platelet and absolute neutrophil count every 3 months (90 days) according to routine clinical practice. Hematological response will be classified as response (CR and PR vs. NR). CR and PR to treatment will be defined as follows: CR: haemoglobin levels ≥120 g/L, platelet count ≥100 x 109/L, and neutrophil count ≥1.5 x 109/L. PR: haemoglobin levels ≥80 g/L, platelet count ≥20 x 109/L (transfusion independent), and neutrophil count ≥0.5 x 109/L.
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Time frame: 2010-2022
5. Best hematological response during each treatment line (CR, PR, and NR).
Percentage of patients with CR, PR and NR as the best hematological response during each treatment line and the 95% CI will be calculated.
Time frame: 2010-2022
6. Overall survival, defined as the time elapsed since first-line treatment initiation until death from any cause.
The OS will be calculated as the time elapsed from first-line treatment initiation to death. Patients will be censored at the date of last follow-up if still alive at the time of the analysis. The probability of OS will be estimated using the Kaplan-Meier method. Median OS (range) and 95% CI will be calculated.
Time frame: 2010-2022
7. Relapse-free survival, defined as the time elapsed since complete or partial remission achievement until relapse or death from any cause
RFS will be calculated as the time elapsed since complete or partial remission achievement until relapse or death from any cause. The probability of RFS will be estimated using the Kaplan-Meier method. Median RFS (range) and 95% CI will be calculated
Time frame: 2010-2022
8. Progression-free survival, defined as the time elapsed since treatment initiation until disease progression or death from any cause.
PFS will be calculated as the time elapsed since treatment initiation until disease progression or death from any cause. Patients will be censored at the date of last follow-up if still alive or without disease progression at the time of the analysis. The probability of PFS will be estimated using the Kaplan-Meier method. Median PFS (range) and 95% CI will be calculated.
Time frame: 2010-2022
9. Percentage of patients with bleeding events an infections leading to hospitalization or death during the follow-up period.
A descriptive analysis will be performed on the bleeding episodes and/or infection reported during each treatment line received, including the absolute and relative frequencies and the corresponding 95% CI.
Time frame: 2010-2022