Effect of cell determinant (CD)34(+) cell dose on the cost and consequences of peripheral blood stem cell transplantation for non-Hodgkin's lymphoma patients in front-line therapy

The aim of this study was to assess the effect of cell determinant (CD)34- cell dose on the cost and consequences of peripheral blood stem cell trans plantation for non-Hodgkin's lymphoma (NHL) patients in front-line therapy. Resource utilisation, length of aplasia, overall (OS) and event-free survi val (EFS) were assessed for 63 patients. Economic data were calculated taki ng into account harvest, hospitalisation, blood product requirements and dr ugs required until discharge. The point of view of the Hospital Institution was chosen. A significantly earlier haematopoietic engraftment was achieve d in patients with a count of more than 5x10(6) CD34 + /kg. There were no d ifferences for OS and EFS. A high CD34 + cell content resulted in a total c ost saving of $4210. This was principally related to a significant reductio n in the length of hospitalisation (-$3010) and platelet and red blood cell transfusions (-$815), although the latter was not significant. Several sen sitivity analyses showed the robustness of our results. A CD34 + cell dose higher than 5x10(6)/kg appeared to be optimal for clinical and economic con siderations in NHL patients undergoing transplantation in front-line therap y. (C) 2000 Elsevier Science Ltd. All rights reserved.