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Economic Analysis

Do minitransplants have minicosts? A cost comparison between myeloablative and nonmyeloablative allogeneic stem cell transplant in patients with acute myeloid leukemia

Bone Marrow Transplantation volume 36, pages 649–654 (2005)Cite this article

Summary:

Allogeneic hematopoietic stem cell transplantation (SCT) is a widely used, cost-intensive procedure. Although pretransplant nonmyeloablative (NMA) or reduced-intensity conditioning regimens appear very promising, prospective studies comparing this approach with the conventional myeloablative (MA) approach in specific hematologic diseases are necessary, especially in patients in whom the conventional approach is not contraindicated. Cost may be an important factor in the decision-making process. We compared the costs of MA and NMA transplants in patients with acute myeloid leukemia (AML). We estimated 1-year resource utilization in 12 consecutive MA patients (median age: 39 years) and in 11 consecutive NMA patients (median age: 58 years) who underwent HLA-identical sibling SCT for AML. Resources care expenses were valued using the average daily rate for personnel costs, supplies, and room costs. Other data were directly collected from the patients' charts. Despite a trend for lower costs in NMA patients during the first 6 months, costs during the 6–12-month period were significantly higher after NMA due to late complications and readmissions (P=0.03). Finally, mean 1-year costs were not different in MA and NMA patients (P=0.75). Prospective studies comparing conventional and NMA approaches in homogeneous populations should include economic items.

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Acknowledgements

We thank the financial departments of Henri Mondor Hospital and St Louis Hospital for assistance in providing cost data especially related to room expenses. The authors also thank Maryse Pizzato, Marc Legrand, Martine Mathieu, and the student nurses of the Departement de Santé Publique of Henri Mondor hospital for their help with data management. They especially thank Pamela Johnson for her editorial assistance. Grant support by the French Ministry of Health (Grant PHRC 96029) and the Caisse Nationale d'Assurance Maladie des Professions Indépendantes is acknowledged. This study has been orally presented at the 30th Annual Meeting of the European Group for Blood and Marrow Transplantation, Barcelona, March 28–31, 2004.

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Authors and Affiliations

  1. Service d'Hématologie clinique, CHU Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP/HP) and University Paris 12, Créteil, France

    C Cordonnier, S Maury, C Pautas, J Beaune & M Kuentz

  2. Unité de Greffe de Moëlle, Hôpital Saint-Louis (AP/HP), Paris, France

    H Esperou & E Glückman

  3. Etablissement Français du Sang (EFS), Créteil, France

    M Rodet & J-L Beaumont

  4. Service de Radiothérapie, Hôpital Henri Mondor (AP/HP), Paris, France

    J-L Lagrange

  5. Laboratoire de Thérapie Cellulaire, EFS, Créteil, France

    H Rouard

  6. Délégation à la Recherche Clinique (AP/HP), Paris, France

    F Bassompierre

  7. Département de Santé Publique, Hôpital Henri Mondor (AP/HP), Créteil, France

    I Durand-Zaleski

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  1. C Cordonnier
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Correspondence to C Cordonnier.

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Cordonnier, C., Maury, S., Esperou, H. et al. Do minitransplants have minicosts? A cost comparison between myeloablative and nonmyeloablative allogeneic stem cell transplant in patients with acute myeloid leukemia. Bone Marrow Transplant 36, 649–654 (2005). https://doi.org/10.1038/sj.bmt.1705109

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