AN ECONOMIC-EVALUATION OF PERIPHERAL-BLOOD STEM-CELL TRANSPLANTATION AS AN ALTERNATIVE TO AUTOLOGOUS BONE-MARROW TRANSPLANTATION IN MULTIPLE-MYELOMA

Autologous peripheral blood stem cell transplantation (PBSCT) is incre asingly being utilised as an alternative to autologous bone marrow tra nsplantation (ABMT) in the treatment of malignant diseases, We have pe rformed a pharmacoeconomic study using cost-minimisation analysis to e valuate the two techniques in a population of multiple myeloma patient s undergoing PBSCT (n = 37) or ABMT (n = 14). In the PBSCT group, the time to >0.5 x 10(9)/l neutrophils was significantly shorter (16 vs 22 days; P = 0.0019) as was the time to >50 x 10(9)/l platelets (19 vs 2 7 days; P = 0.0019), The faster haematopoietic recovery resulted in a reduced period of intravenous antibiotic therapy (12 vs 19 days; P < 0 .0001), reduced requirements for platelet transfusions (12 vs 31.5 uni ts; P = 0.0005), and ultimately, a significant reduction in duration o f hospitalisation (19 vs 27.5 days; P < 0.0001), These clinical benefi ts translated into economic benefits such that the total cost in the P BSCT group was 27.5 % less than in the ABMT group (< pound 7995 vs < p ound 11 026; P = 0.0001), We conclude that the use of PBSCT as an alte rnative to ABMT in patients with multiple myeloma is associated with d emonstrable economic advantages in addition to clinical benefits.