 |
 |
|
Home |
Current Issue |
Past Issues |
In the Clinic |
ACP Journal Club |
CME |
Collections |
Audio/Video |
Mobile |
Subscribe |
Tools |
Help |
ACP Online
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
15 April 1997 | Volume 126 Issue 8 | Pages 600-607
Background: Previous studies have suggested that peripheral blood stem cell (PBC) transplantation has an advantage over autologous bone marrow transplantation.
Objective: To compare the hematologic recovery and costs associated with PBC transplantation with those associated with autologous bone marrow transplantation in patients receiving high-dose chemotherapy for solid tumors or lymphomas.
Design: Multicenter, randomized, controlled clinical trial.
Setting: French Federation of Cancer Centers, located in cancer facilities or public hospitals with transplantation units.
Patients: Children and adults with solid tumors or lymphomas who were candidates for high-dose chemotherapy.
Interventions: Bone marrow or filgrastim-mobilized PBCs.
Measurement: The major end point was the duration of thrombocytopenia (platelet count < 50 x 109/L). An economic evaluation of both types of transplantation was done prospectively to measure costs and cost-effectiveness.
Results: 129 patients entered the trial; 64 had PBC transplantation, and 65 had bone marrow transplantation. The median duration of thrombocytopenia was 16 days in the PBC group and 36 days in the bone marrow group (P < 0.001). All of the other clinical end points studied (time to last platelet transfusion, duration of granulocytopenia, number of transfusion episodes, and duration of hospitalization) favored PBC transplantation. A cost analysis showed that total cost was decreased by 17% in adults and 29% in children with PBC transplantation; thus, PBC transplantation was clearly more cost-effective than bone marrow transplantation for both platelet and granulocyte recovery.
Conclusion: Transplantation of PBCs is associated with more rapid hematologic recovery than is bone marrow transplantation after high-dose chemotherapy for solid tumors or lymphomas. Furthermore, global costs are lower and cost-effectiveness ratios are better with PBC transplantation.
Author and Article Information
For author affiliations and current author addresses, see end of text.
ARTICLE
Peripheral Blood Stem Cell and Bone Marrow Transplantation for Solid Tumors and Lymphomas: Hematologic Recovery and Costs: A Randomized, Controlled Trial
Acknowledgments: The authors thank the Federation Nationale des Centres de Lutte Contre le Cancer for promoting this study and Lorna Saint Ange for linguistic revision of the manuscript.
Grant Support: In part by the Laboratoire AMGEN France.
Requests for Reprints: Olivier Hartmann, MD, Institut Gustave-Roussy, Rue Camille Desmoulins, 94 800 Villejuif, France.
Current Author Addresses: Dr. Hartmann: Institut Gustave-Roussy, Rue Camille Desmoulins, 94 800 Villejuif, France.
This article has been cited by other articles:
|
|
 |
|
  M. Abraham, K. Biyder, M. Begin, H. Wald, I. D. Weiss, E. Galun, A. Nagler, and A. Peled Enhanced Unique Pattern of Hematopoietic Cell Mobilization Induced by the CXCR4 Antagonist 4F-Benzoyl-TN14003 Stem Cells, September 1, 2007; 25(9): 2158 - 2166. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 X. Thomas, S. Suciu, B. Rio, G. Leone, G. Broccia, G. Fillet, U. Jehn, W. Feremans, G. Meloni, M. Vignetti, et al. Autologous stem cell transplantation after complete remission and first consolidation in acute myeloid leukemia patients aged 61 70 years: results of the prospective EORTC GIMEMA AML 13 study Haematologica, March 1, 2007; 92(3): 389 - 396. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Czyz, R. Dziadziuszko, W. Knopinska-Postuszuy, A. Hellmann, L. Kachel, J. Holowiecki, J. Gozdzik, J. Hansz, A. Avigdor, A. Nagler, et al. Outcome and prognostic factors in advanced Hodgkin's disease treated with high-dose chemotherapy and autologous stem cell transplantation: a study of 341 patients Ann. Onc., August 1, 2004; 15(8): 1222 - 1230. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Devine, N. Flomenberg, D. H. Vesole, J. Liesveld, D. Weisdorf, K. Badel, G. Calandra, and J. F. DiPersio Rapid Mobilization of CD34+ Cells Following Administration of the CXCR4 Antagonist AMD3100 to Patients With Multiple Myeloma and Non-Hodgkin's Lymphoma J. Clin. Oncol., March 15, 2004; 22(6): 1095 - 1102. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Locatelli, M. Labopin, J. Ortega, G. Meloni, G. Dini, C. Messina, I. Yaniv, F. Fagioli, V. Castel, P. J. Shaw, et al. Factors influencing outcome and incidence of long-term complications in children who underwent autologous stem cell transplantation for acute myeloid leukemia in first complete remission Blood, February 15, 2003; 101(4): 1611 - 1619. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. H. Cottler-Fox, T. Lapidot, I. Petit, O. Kollet, J. F. DiPersio, D. Link, and S. Devine Stem Cell Mobilization Hematology, January 1, 2003; 2003(1): 419 - 437. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Mohty, M. Kuentz, M. Michallet, J.-H. Bourhis, N. Milpied, L. Sutton, J.-P. Jouet, M. Attal, P. Bordigoni, J.-Y. Cahn, et al. Chronic graft-versus-host disease after allogeneic blood stem cell transplantation: long-term results of a randomized study Blood, October 16, 2002; 100(9): 3128 - 3134. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Hunault-Berger, N. Ifrah, and P. Solal-Celigny Intensive therapies in follicular non-Hodgkin lymphomas Blood, July 30, 2002; 100(4): 1141 - 1152. [Full Text] [PDF]
|
|
|
|
 |
|
 K. Imrie, R. Esmail, R. M. Meyer, and and the Members of the Hematology Disease Site Gro The Role of High-Dose Chemotherapy and Stem-Cell Transplantation in Patients with Multiple Myeloma: A Practice Guideline of the Cancer Care Ontario Practice Guidelines Initiative Ann Intern Med, April 16, 2002; 136(8): 619 - 629. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Prieto, J. Blanch, J. Atala, E. Carreras, M. Rovira, E. Cirera, and C. Gasto Psychiatric Morbidity and Impact on Hospital Length of Stay Among Hematologic Cancer Patients Receiving Stem-Cell Transplantation J. Clin. Oncol., April 1, 2002; 20(7): 1907 - 1917. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Cutler, S. Giri, S. Jeyapalan, D. Paniagua, A. Viswanathan, and J. H. Antin Acute and Chronic Graft-Versus-Host Disease After Allogeneic Peripheral-Blood Stem-Cell and Bone Marrow Transplantation: A Meta-Analysis J. Clin. Oncol., August 15, 2001; 19(16): 3685 - 3691. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. D. Rowley, G. Donaldson, K. Lilleby, W. I. Bensinger, and F. R. Appelbaum Experiences of donors enrolled in a randomized study of allogeneic bone marrow or peripheral blood stem cell transplantation Blood, May 1, 2001; 97(9): 2541 - 2548. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. Paquette, S. T. Dergham, E. Karpf, H.-J. Wang, D. J. Slamon, L. Souza, and J. A. Glaspy Ex vivo expanded unselected peripheral blood: progenitor cells reduce posttransplantation neutropenia, thrombocytopenia, and anemia in patients with breast cancer Blood, October 1, 2000; 96(7): 2385 - 2390. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. E. Champlin, N. Schmitz, M. M. Horowitz, B. Chapuis, R. Chopra, J. J. Cornelissen, R. P. Gale, J. M. Goldman, F. R. Loberiza Jr, B. Hertenstein, et al. Blood stem cells compared with bone marrow as a source of hematopoietic cells for allogeneic transplantation Blood, June 15, 2000; 95(12): 3702 - 3709. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Siena, R. Schiavo, P. Pedrazzoli, and C. Carlo-Stella Therapeutic Relevance of CD34 Cell Dose in Blood Cell Transplantation for Cancer Therapy J. Clin. Oncol., March 13, 2000; 18(6): 1360 - 1377. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Blaise, M. Kuentz, C. Fortanier, J. H. Bourhis, N. Milpied, L. Sutton, J.-P. Jouet, M. Attal, P. Bordigoni, J.-Y. Cahn, et al. Randomized Trial of Bone Marrow Versus Lenograstim-Primed Blood Cell Allogeneic Transplantation in Patients With Early-Stage Leukemia: A Report From the Societe Francaise de Greffe de Moelle J. Clin. Oncol., February 1, 2000; 18(3): 537 - 537. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J. Lee, N. Klar, J. C. Weeks, and J. H. Antin Predicting Costs of Stem-Cell Transplantation J. Clin. Oncol., January 5, 2000; 18(1): 64 - 64. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Rizzo, G. B. Vogelsang, S. Krumm, B. Frink, V. Mock, and E. B. Bass Outpatient-Based Bone Marrow Transplantation for Hematologic Malignancies: Cost Saving or Cost Shifting? J. Clin. Oncol., September 1, 1999; 17(9): 2811 - 2811. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. A. Schulman, R. Birch, B. Zhen, N. Pania, and C. H. Weaver Effect of CD34+ Cell Dose on Resource Utilization in Patients After High-Dose Chemotherapy With Peripheral-Blood Stem-Cell Support J. Clin. Oncol., April 1, 1999; 17(4): 1227 - 1227. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.A. Shipp, M.D. Abeloff, K.H. Antman, G. Carroll, A. Hagenbeek, M. Loeffler, E. Montserrat, J.A. Radford, G. Salles, N. Schmitz, et al. International Consensus Conference on High-Dose Therapy With Hematopoietic Stem Cell Transplantation in Aggressive Non-Hodgkin's Lymphomas: Report of the Jury J. Clin. Oncol., January 1, 1999; 17(1): 423 - 423. [Full Text] [PDF]
|
|
|
|
 |
|
 Progenitor cell transplantation DTB, August 1, 1997; 35(8): 62 - 64. [Abstract] [Full Text] [PDF]
|
|
Article
