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Conditioning Regimens

Lower costs associated with hematopoietic cell transplantation using reduced intensity vs high-dose regimens for hematological malignancy

Bone Marrow Transplantation volume 40, pages 209–217 (2007)Cite this article

Abstract

We compared inpatient and outpatient costs alongside clinical outcomes associated with hematopoietic cell transplantation between 2000 and 2003 with high-dose regimens (HDCT, n=185) and with reduced intensity regimens (RICT, n=90) from human leukocyte antigen (HLA)-matched donors for patients with hematological malignancies. With a comparable median follow-up of 3 years, long-term clinical outcomes, including cumulative incidence of chronic graft-vs-host disease, disease-free survival and overall survival, were similar between the two groups. In the univariate analysis, median costs for the first 100 days ($104 380 vs $42 149) and 1 year ($128 253 vs $80 499) in the HDCT group were higher than those in the RICT group. Median days of hospitalization are also higher for HDCT recipients (39 vs 21), although the number of outpatient clinic visits for HDCT recipients were fewer compared to that for RICT recipients (16 vs 25) during the first year. Adjusting for patient characteristics, RICT recipients had approximately 16 fewer days of hospitalization and cost $53 030 less than HDCT recipients within the first year after transplantation. Our data suggest that substantially lower costs and fewer days of hospitalization within the first year after RICT procedures can be obtained with no compromise of long-term clinical outcomes compared to HDCT procedures.

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Acknowledgements

We thank our colleagues at the Dana-Farber Cancer Institute and Brigham and Women's Hospital and our patients for sharing their experiences with us. We also thank Qiheng Yang, Daniel J Quinn, Robin R Junkins, Denise Sullivan, Celeste Daye and Mohammed Yousuf for their help in gathering clinical and cost information, and Bridget Neville for her help with SAS coding.

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Authors and Affiliations

  1. Division of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA

    A M Saito, C Cutler, V T Ho, J H Antin, R J Soiffer & E P Alyea

  2. Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA

    D Zahrieh

  3. Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA

    S J Lee

  4. Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    S J Lee

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  1. A M Saito
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Correspondence to A M Saito.

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Saito, A., Zahrieh, D., Cutler, C. et al. Lower costs associated with hematopoietic cell transplantation using reduced intensity vs high-dose regimens for hematological malignancy. Bone Marrow Transplant 40, 209–217 (2007). https://doi.org/10.1038/sj.bmt.1705733

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