CLINICAL AND ECONOMIC COMPARISON OF LENOGRASTIM-PRIMED BLOOD-CELLS (BC) AND BONE-MARROW (BM) ALLOGENEIC TRANSPLANTATION

The study presented is a clinical and economic comparison of bone marr ow (BM) and blood cells (BC) allogeneic transplantation. We performed a case-control study to compare 17 patients receiving allogeneic BC tr ansplant in a pilot study to an historical group of 17 patients allogr afted with BM. We evaluated the clinical outcomes and the direct medic al costs of transplantation from conditioning regimen until day 100 by detailed observation of patients' medical records. Patients in the BC group received a median of 8 x 10(6)/kg CD34(+) cells (1.58-29.1) and 266 x 10(6)/kg CD3(+) cells (128-469). All patients had neutrophil en graftment with a median of 14 days in the BC group vs 19 days in the B M group (P < 0.05). The Kaplan-Meier estimation of the median number o f days to a platelet count of >25 x 10(9)/l, independent of platelet t ransfusion, was significantly shorter in the BC group (15 (9-74)) comp ared with the BM group (25 (15-45)), Acute graft-versus-host disease ( AGVHD) of grade greater than or equal to 2 was not significantly diffe rent between the two groups. Patients treated with BC presented a US$1 6 134 decrease in the cost of the first 100 days (29%, P = 0.006). Our comparison suggested that platelet reconstitution and total costs wer e in favor of the BC group.