1. ¹Service d'Hématologie clinique, CHU Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP/HP) and University Paris 12, Créteil, France
2. ²Unité de Greffe de Moëlle, Hôpital Saint-Louis (AP/HP), Paris, France
3. ³Etablissement Français du Sang (EFS), Créteil, France
4. ⁴Service de Radiothérapie, Hôpital Henri Mondor (AP/HP), Paris, France
5. ⁵Laboratoire de Thérapie Cellulaire, EFS, Créteil, France
6. ⁶Délégation à la Recherche Clinique (AP/HP), Paris, France
7. ⁷Département de Santé Publique, Hôpital Henri Mondor (AP/HP), Créteil, France

Correspondence: Professor C Cordonnier, Service d'Hématologie Clinique, Hôpital Henri Mondor, 94000 Créteil, France. E-mail: carlcord@club-internet.fr

Received 18 March 2005; Accepted 21 June 2005; Published online 25 July 2005.

Abstract

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.