Economic analysis of unrelated allogeneic bone marrow transplantation: Results from the randomized clinical trial of T-cell depletion vs unmanipulated grafts for the prevention of graft-versus-host disease

G. de Lissovoy, D. Hurd, S. Carter, P. Beatty, M. Ewell, J. Henslee-Downey, N. Kernan, S. Yanovich, D. Weisdorf

Research output: Contribution to journalArticlepeer-review

Abstract

Unrelated-donor marrow transplantation is a potential option for transplant candidates lacking a compatible related donor. The T-cell Depletion Study compared the 3-year disease-free survival for patients receiving T-cell-depleted (TCD) donor marrow (n=203) vs unmanipulated donor marrow with methotrexate and cyclosporine (M/C) (n=207). Hospital costs during index admission were documented with billing data, while hospital costs during subsequent 6-month follow-up were estimated from case report forms. Patients with index admission billing were included in the analysis (TCD=119, M/C=127). Total hospital length of stay (LOS) was similar across groups, with medians 47.0 days for TCD and 52.0 days for M/C (P=0.72). Total hospital costs were comparable, $145 115 vs $141 981 (P=0.63) for TCD and M/C, respectively. However, controlling for site and patient characteristics, TCD was associated with a 12.1% reduction in LOS for the index admission (95% CI-19.4%, -4.3%). Independent of treatment, HLA matching (6/6) was associated with an 8.6% (95% CI -17.4%, +1.2%) reduction in the index admission LOS, while cost was lower by 15.8% (95% CI -26.7%, -3.3%). Treatment costs were similar for TCD and M/C study groups. Savings on reduced cost for treating acute graft-versus-host disease were likely offset by increase in serious infections in the TCD arm.

Original languageEnglish (US)
Pages (from-to)539-546
Number of pages8
JournalBone Marrow Transplantation
Volume36
Issue number6
DOIs
StatePublished - Sep 2005
Externally publishedYes

Keywords

  • Cost-effectiveness
  • Economics
  • T-cell depletion

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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