title: Blood component use and associated costs after standard dose chemotherapy--a prospective analysis of routine hospital care in lymphoproliferative disorders and NSCLC in Germany.
abstract: OBJECTIVE
  The purpose of this study was to describe blood component (BC) use and respective cost after standard dose chemotherapy (CT) in routine hospital care.
  
  
  METHODS
  Analysis of data from a prospective, multicenter, longitudinal, observational study on lymphoproliferative disorder (LPD) and non-small cell lung cancer (NSCLC) patients undergoing first or second line standard dose (immuno-)CT. Data were collected from patient interviews and pre-planned chart reviews. Costs of BC are presented from provider perspective.
  
  
  RESULTS
  One hundred eighty patients (n = 85 NSCLC, n = 95 LPD) receiving 189 CT lines/633 CT cycles) were evaluable (mean ± SD age, 59 ± 13.2 years, 68% stage III/IV, 14% Eastern Cooperative Oncology Group ≥ 2). During 11% of cycles, BC were transfused to 27% of patients (n = 49; n = 22 NSCLC, n = 27 LPD). Of 310 transfused units (TU), 68% were red blood cells (RBC). Mean number of TU per cycle with transfusion was 3.3 ± 2.9 (median = 2, range = 2-17) for RBC, 4.8 ± 6.8 (median = 2, range = 1-23) for platelets (PLT) and 12.8 ± 14.6 (median = 8, range = 2-33) for fresh frozen plasma (FFP). Fifteen per cent of RBC units, 60% of PLT units and 92% of FFP in this study were transfused in cycles with sepsis. Mean BC cost per CT line were euro 602 ± 1,458 (median = 135, range = 135-9,385; NSCLC: euro 292 ± 376, median = 135, range = 135-2,124; LPD: euro 1,010 ± 2,137, median = 212, range = 135-9,385, p = 0.2137). For 55% of transfused RBC units, haemoglobin levels on the day of transfusion were 8.0-8.9 g/dl, for 38% <8 g/dl and for 7% ≥ 9 g/dl. Seventy-five per cent of PLT units were transfused at a PLT count <11,000/μl and 21% at 20,000-11,000/μl.
  
  
  CONCLUSIONS
  The results reflect the diversity of BC use after standard dose CT. High transfusion need is associated with infectious complications, i.e. sepsis emphasising the need for adequate prophylaxis and further knowledge of baseline risk factors.
authors.affiliation: Krankenhausapotheke, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. bernadette.p@gmx.de
authors.forename: Bernadette
authors.initials: B
authors.lastname: Paessens
authors.forename: Angela
authors.initials: A
authors.lastname: Ihbe-Heffinger
authors.forename: Christoph
authors.initials: C
authors.lastname: von Schilling
authors.forename: Rita
authors.initials: R
authors.lastname: Shlaen
authors.forename: Rudolf
authors.initials: R
authors.lastname: Bernard
authors.forename: Christian
authors.initials: C
authors.lastname: Peschel
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schramm
authors.forename: Karin
authors.initials: K
authors.lastname: Berger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D016913:Blood Component Transfusion / Q000191:economics / Q000379:methods*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D015331:Cohort Studies; D005260:Female; D005858:Germany; D017048:Health Care Costs; D006801:Humans; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000188:drug therapy*; D008232:Lymphoproliferative Disorders / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents