EFFECT OF GRANULOCYTE GROWTH-FACTOR ON TH E COST OF BONE-MARROW AUTOGRAFTS IN ONCOHAEMATOLOGY

Objective: It is now possible to achieve prolonged remission of malign ant lymphoma and certain cancers with high-dose chemotherapy followed by autograft with haematopoietic stem cells. We tested such a protocol , evaluating haematologic recovery, in order to determine the total co st of hospitalization. Methods: Sixteen patients were included in the study, 7 had severe or relapsing lymphoma, 7 had breast cancer or canc er of the ovary and 2 had cancer of the testicule. Mean age was 34 yea rs, 14 patients reached complete remission and relapse occurred in 2. Ten patients were given granulocyte growth factor and 6 were given a p lacebo. Results: The duration of aplasia (number of days with a white cell count below 1 x 10(9)1) ranged from 10 to 32 days. In patients tr eated with granulocyte growth factor, it was shorter (16 vs 22 days) a s was hospitalization time (27 vs 33 days). The cost of the autograft ranged from 100,000 FF to 250,000 FF and the average cost for the 16 p atients was 149,500 FF including : 83,600 FF (56.4%) for hospitalizati on itself, 33,200 FF (22%) for drugs, mostly antibiotics, and 19,000 F F (13%) for laboratory examinations and 14,000 FF (9%) for blood trans fusions. Total cost was lower in patients given granulocyte growth fac tor, 142,000 FF vs 166,000 FF for those given placebo. Conclusion: In order to shorten the duration of the aplasia period, haematopoietic gr owth factors are widely used in autograft protocols. Our findings give an evaluation of the cost in 16 patients and show that cost decreases in patients given granulocyte growth factor This reduction in cost is related to a lower hospitalization cost and not a reduction in the nu mber of drugs and transfusions required