Kuok, Chiu Fai. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 139-154). / Abstract and appendix also in Chinese. / Abstract --- p.i / Abstract (in Chinese) --- p.iv / Acknowledgements --- p.vi / Table of Contents --- p.vii / List of Tables --- p.xi / List of Figures --- p.xiv / List of Abbreviations --- p.xv / Chapter Chapter 1 --- Introduction / Chapter 1.1 --- Introduction --- p.1 / Chapter 1.2 --- The Impact of Malignant Diseases and Multiple Myeloma --- p.4 / Chapter 1.3 --- Pharmacoeconomics --- p.6 / Chapter 1.4 --- Macao Healthcare System --- p.9 / Chapter 1.5 --- Study Hypothesis --- p.12 / Chapter 1.6 --- Study Objectives --- p.12 / Chapter 1.7 --- Perspective of the Study --- p.13 / Chapter Chapter 2 --- Literature Review / Chapter 2.1 --- Hematopoietic System --- p.14 / Chapter 2.1.1 --- Specific Blood Cell Lineages and Blood Cells --- p.15 / Chapter 2.1.2 --- Bone Marrow Microenvironment --- p.19 / Chapter 2.2 --- The Hematologic Malignancies --- p.20 / Chapter 2.2.1 --- Leukemia --- p.21 / Chapter 2.2.2 --- Lymphoma --- p.23 / Chapter 2.2.3 --- Plasma Cell Disorders --- p.24 / Chapter 2.3 --- Multiple Myeloma --- p.25 / Chapter 2.3.1 --- Epidemiology --- p.26 / Chapter 2.3.2 --- Pathology --- p.29 / Chapter 2.3.3 --- Clinical Presentation and Disease Complications --- p.31 / Chapter 2.3.4 --- Classification and Diagnostic Criteria --- p.35 / Chapter 2.3.5 --- Disease Staging and Prognosis --- p.42 / Chapter 2.3.6 --- Treatment --- p.45 / Chapter 2.3.6.1 --- Treatment Regimens and Strategies --- p.47 / Chapter 2.3.6.1.1 --- Standard Chemotherapy --- p.48 / Chapter 2.3.6.1.1.1 --- Melphalan-based Regimens --- p.51 / Chapter 2.3.6.1.1.2 --- VAD-based Regimens --- p.52 / Chapter 2.3.6.1.1.3 --- High-dose Glucocorticoid Regimens --- p.53 / Chapter 2.3.6.1.2 --- Treatment Strategies --- p.53 / Chapter 2.3.6.1.2.1 --- Initial Chemotherapy --- p.53 / Chapter 2.3.6.1.2.2 --- High-dose Chemotherapy --- p.55 / Chapter 2.3.6.1.2.3 --- Newer Therapeutic Agents for Multiple Myeloma --- p.58 / Chapter 2.3.6.1.2.4 --- Salvage Chemotherapy --- p.60 / Chapter 2.3.6.2 --- Treatment Responses --- p.63 / Chapter 2.3.6.3 --- Treatment for Disease Complications --- p.66 / Chapter Chapter 3 --- Methodology / Chapter 3.1 --- Study Design --- p.69 / Chapter 3.2 --- Patients Selection Criteria --- p.71 / Chapter 3.2.1 --- For Retrospective Cost Analysis --- p.71 / Chapter 3.2.2 --- For Health-related Quality of Life Measurement --- p.71 / Chapter 3.3 --- Patient Screening --- p.72 / Chapter 3.4 --- Data Collection --- p.72 / Chapter 3.5 --- Overview of Assessment Methods --- p.73 / Chapter 3.5.1 --- Outcomes --- p.73 / Chapter 3.5.2 --- Cost Analysis --- p.74 / Chapter 3.5.3 --- Cost Effectiveness Analysis --- p.74 / Chapter 3.5.4 --- Cost Utility Analysis --- p.75 / Chapter 3.5.5 --- Health-related Quality of Life Assessment --- p.75 / Chapter 3.6 --- Statistical Analysis --- p.76 / Chapter 3.7 --- Ethic approval --- p.77 / Chapter Chapter 4 --- Results / Chapter 4.1 --- Study Population --- p.78 / Chapter 4.1.1 --- Cost and Pharmacoeconomic Analysis --- p.78 / Chapter 4.1.2 --- Health-related Quality of Life Assessment --- p.79 / Chapter 4.2 --- Study Results --- p.81 / Chapter 4.2.1 --- Comparison of All Patients --- p.81 / Chapter 4.2.1.1 --- Differences in Treatment Protocols --- p.81 / Chapter 4.2.1.2 --- Differences in Treatment Responses --- p.82 / Chapter 4.2.1.3 --- Differences in Treatment Outcomes --- p.82 / Chapter 4.2.1.4 --- Differences in Treatment Costs --- p.84 / Chapter 4.2.2 --- Comparison for Patients Treated by Melphalan-based Regimens and VAD-based Regimens --- p.90 / Chapter 4.2.2.1 --- Differences in Treatment Responses --- p.90 / Chapter 4.2.2.2 --- Differences in Treatment Outcomes --- p.90 / Chapter 4.2.2.3 --- Differences in Treatment Costs --- p.93 / Chapter 4.2.3 --- Melphalan-based Regimens Versus VAD-based Regimens by Patients with Different DS Staging --- p.96 / Chapter 4.2.3.1 --- Patients in Stage 3-A MM --- p.96 / Chapter 4.2.3.2 --- Patients in Stage 3-B MM --- p.98 / Chapter 4.2.4 --- Melphalan-based Regimens versus VAD-based Regimens in Patients with Different IS Staging --- p.101 / Chapter 4.2.4.1 --- Patients in Stage I MM --- p.101 / Chapter 4.2.4.2 --- Patients in Stage II MM --- p.104 / Chapter 4.2.4.3 --- Patients in Stage III MM --- p.107 / Chapter 4.2.5 --- Comparison for Patients with and without Transplantation --- p.110 / Chapter 4.2.6 --- Cost-effectiveness Assessment --- p.117 / Chapter 4.2.7 --- Cost-utility Assessment --- p.118 / Chapter 4.2.8 --- Sensitivity Analysis --- p.119 / Chapter 4.2.9 --- Health-related Quality of Life Assessment --- p.120 / Chapter Chapter 5 --- Discussion and Conclusion / Chapter 5.1 --- Summary of Results --- p.123 / Chapter 5.2 --- Implication for Treatment --- p.126 / Chapter 5.3 --- Economic Evaluation --- p.129 / Chapter 5.4 --- Health-related Quality of Life --- p.132 / Chapter 5.5 --- Limitations of the Study --- p.134 / Chapter 5.6 --- Conclusion and Implications for Future Studies --- p.135 / Appendix --- p.137 / References --- p.139