Effect of cell determinant (CD)34+ cell dose on the cost and consequences of peripheral blood stem cell transplantation for non-Hodgkin's lymphoma patients in front-line therapy.
The aim of this study was to assess the effect of cell determinant (CD)34+ cell dose on the cost and consequences of peripheral blood stem cell transplantation for non-Hodgkin's lymphoma (NHL) patients in front-line therapy. Resource utilisation, length of aplasia, overall (OS) and event-free survival (EFS) were assessed for 63 patients. Economic data were calculated taking into account harvest, hospitalisation, blood product requirements and drugs required until discharge. The point of view of the Hospital Institution was chosen. A significantly earlier haematopoietic engraftment was achieved in patients with a count of more than 5 x 10(6) CD34+/kg. There were no differences for OS and EFS. A high CD34+ cell content resulted in a total cost saving of $4210. This was principally related to a significant reduction in the length of hospitalisation (-$3010) and platelet and red blood cell transfusions (-$815), although the latter was not significant. Several sensitivity analyses showed the robustness of our results. A CD34+ cell dose higher than 5 x 10(6)/kg appeared to be optimal for clinical and economic considerations in NHL patients undergoing transplantation in front-line therapy.
Limat
S
S
Department of Pharmacy, Besançon University Hospital, France.
Woronoff-Lemsi
M C
MC
Milpied
N
N
Chartrin
I
I
Ifrah
N
N
Deconinck
E
E
Gressin
R
R
Colombat
P
P
Cahn
J Y
JY
Arveux
P
P
D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001781:Blood Component Removal; D003362:Cost-Benefit Analysis; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004306:Dose-Response Relationship, Immunologic; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006085:Graft Survival; D019650:Hematopoietic Stem Cell Mobilization / Q000191:economics / Q000379:methods; D018380:Hematopoietic Stem Cell Transplantation / Q000191:economics / Q000379:methods*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000191:economics / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
D018952:Antigens, CD34; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone