AUTOLOGOUS PERIPHERAL-BLOOD PROGENITOR-CELL TRANSPLANTATION VERSUS AUTOLOGOUS BONE-MARROW TRANSPLANTATION FOR ADULTS AND CHILDREN WITH NONLEUKEMIC MALIGNANT DISEASE - A RANDOMIZED ECONOMIC-STUDY

A prospective economic analysis of autologous peripheral blood progeni tor-cell transplantation (PBPCT) versus autologous bone marrow transpl antation (BMT) was performed as part of a randomised clinical trial in 129 patients (adults and children) receiving high-dosage antineoplast ic therapy for non-leukaemic malignant disease. The clinical assessmen t criteria of the study were the duration of thrombocytopenia(<30 x 10 (9)/L and <50 x 10(9)/L) and of granulocytopenia (<0.5 x 10(9)/L. The cost of medical resources used was the primary economic end-point. We also calculated the cost of reaching 2 specified haematological end-po ints: platelet recovery (greater than or equal to 30 x 10(9)/L) and gr anulocyte recovery (greater than or equal to 0.5 x 10(9)/L). Economic analysis was based on the French hospital perspective. Haematological recovery vas significantly quicker in the PBPCT groups (adults and chi ldren) compared with the BMT groups. Economic study revealed that the PBPCT groups were clearly less expensive with regard to costs up to di scharge (17% decrease of the average cost for adults and 29% for child ren) and those associated with specified haematological end-points. Th e global costs of PBPCT were lower than those of BMT for these adult a nd paediatric populations. Economic arguments can clearly be added to clinical ones in favour of substitution of autologous PBPCT for autolo gous BMT. International comparisons of diffusion of PBPCT could be of great interest for further economic research into medical innovation.