[Influence of the granulocyte growth factor on the cost of bone marrow autografts in oncologic hematology].
OBJECTIVE
It is now possible to achieve prolonged remission of malignant lymphoma and certain cancers with high-dose chemotherapy followed by autograft with haematopoietic stem cells. We tested such a protocol, evaluating haematologic recovery, in order to determine the total cost of hospitalization.


METHODS
Sixteen patients were included in the study, 7 had severe or relapsing lymphoma, 7 had breast cancer or cancer of the ovary and 2 had cancer of the testicule. Mean age was 34 years, 14 patients reached complete remission and relapse occurred in 2. Ten patients were given granulocyte growth factor and 6 were given a placebo.


RESULTS
The duration of aplasia (number of days with a white cell count below 1 x 10(9)1) ranged from 10 to 32 days. In patients treated with granulocyte growth factor, it was shorter (16 vs 22 days) as was hospitalization time (27 vs 33 days). The cost of the autograft ranged from 100,000 FF to 250,000 FF and the average cost for the 16 patients was 149,500 FF including: 83,600 FF (56.4%) for hospitalization itself, 33,200 FF (22%) for drugs, mostly antibiotics, and 19,000 FF (13%) for laboratory examinations and 14,000 FF (9%) for blood transfusions. Total cost was lower in patients given granulocyte growth factor, 142,000 FF vs 166,000 FF for those given placebo.


CONCLUSIONS
In order to shorten the duration of the aplasia period, haematopoietic growth factors are widely used in autograft protocols. Our findings give an evaluation of the cost in 16 patients and show that cost decreases in patients given granulocyte growth factor. This reduction is cost is related to a lower hospitalization cost and not a reduction in the number of drugs and transfusions required.
Brice
P
P
Institut d'Hématologie, Hôpital Saint-Louis, Paris.
Godin
S
S
Libert
O
O
Marolleau
J P
JP
Makki
J
J
Extra
J M
JM
Faure
P
P
Gisselbrecht
C
C
D000328:Adult; D016026:Bone Marrow Transplantation / Q000191:economics*; D003365:Costs and Cost Analysis; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000191:economics* / Q000627:therapeutic use; D006801:Humans; D007902:Length of Stay; D008223:Lymphoma / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000601:surgery; D014182:Transplantation, Autologous
D016179:Granulocyte Colony-Stimulating Factor