Leukodepleted-ABO-identical blood components in the treatment of hematologic malignancies: a cost analysis.
To assess the effect of ABO-identical, filtration leukodepleted transfusions on resource consumption and costs of care we performed a cohort study in consecutive adult patients admitted for induction therapy of acute myeloid or lymphoid leukemia during 1985-92 (n = 120) and consecutive adult patients admitted for autologous bone marrow transplantation for Hodgkin's or non-Hodgkin's lymphoma during 1989-1991 in our university hospital. Patients with acute leukemia received either ABO unmatched, unfiltered transfusions (1985-89), ABO identical, unfiltered transfusions (1987-90), or ABO identical, filtered transfusions (1990-92). Patients with lymphoma received either ABO unmatched, unfiltered transfusions (1989-90) or ABO identical, filtered transfusions (1990-91). Mean platelet transfusion requirements per patient decreased with ABO identical platelets and filtered transfusions: from 143 to 71 units in the transplant setting; from 146 to 83 in acute leukemia (P < 0.05). Mean hospital ancillary service charges in 1992 dollars decreased with ABO identical platelets and filtered transfusions approximately $14,000 per patient for acute leukemia and $26,000 for for lymphoma. Per patient actual costs for filters ($643 in transplantation for lymphoma and $875 in leukemia) were offset by savings in actual blood component purchase costs alone ($4,127 in lymphoma and $3,283 in leukemia). In our setting, introduction of ABO identical platelets and filtration leukodepletion were implemented with substantial decreases in costs.
Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, New York.
N
N
Blumberg
J M
JM
Heal
S A
SA
Kirkley
J F
JF
DiPersio
A P
AP
Rapoport
J M
JM
Rowe
D000017:ABO Blood-Group System; D000208:Acute Disease; D000328:Adult; D000368:Aged; D001788:Blood Grouping and Crossmatching; D001804:Blood Transfusion, Autologous / Q000191:economics*; D016465:Bone Marrow Purging; D016026:Bone Marrow Transplantation / Q000191:economics*; D003365:Costs and Cost Analysis; D006801:Humans; D007938:Leukemia / Q000628:therapy*; D007962:Leukocytes; D008223:Lymphoma / Q000628:therapy*; D008875:Middle Aged; D012074:Remission Induction
D000017:ABO Blood-Group System