Lower costs associated with hematopoietic cell transplantation using reduced intensity vs high-dose regimens for hematological malignancy
Lower costs associated with hematopoietic cell transplantation using reduced intensity vs high-dose regimens for hematological malignancy
复制标题
DOI：
10.1038/sj.bmt.1705733
复制
发表时间：
2007-08-01
影响因子：
4.8
通讯作者：
Lee, S. J.
中科院分区：
文献类型：
--
作者：
Saito, A. M.;Zahrieh, D.;Lee, S. J.
我们比较了2000年至2003年期间，采用高剂量方案（HDCT，n = 185）和低强度方案（RICT，n = 90）从人类白细胞抗原（HLA）匹配的供体进行造血细胞移植治疗恶性血液病患者的住院和门诊费用以及与造血细胞移植相关的临床结局。中位随访时间为3年，两组的长期临床结局（包括慢性移植物抗宿主病的累积发生率、无病生存率和总生存率）相似。在单因素分析中，HDCT组前100天（104 380美元vs 42 149美元）和1年（128 253美元vs 80 499美元）的中位费用高于RICT组。HDCT接受者的中位住院天数也更高（39 vs 21），尽管第一年HDCT接受者的门诊就诊次数少于RICT接受者（16 vs 25）。根据患者特征进行调整后，RICT接受者在移植后第一年内的住院时间比HDCT接受者少约16天，花费少53030美元。我们的数据表明，与HDCT手术相比，RICT手术后第一年内的住院费用显著降低，住院天数减少，而长期临床结局无影响。
We compared inpatient and outpatient costs alongside clinical outcomes associated with hematopoietic cell transplantation between 2000 and 2003 with high-dose regimens (HDCT, n = 185) and with reduced intensity regimens (RICT, n = 90) from human leukocyte antigen (HLA)-matched donors for patients with hematological malignancies. With a comparable median follow-up of 3 years, long-term clinical outcomes, including cumulative incidence of chronic graft-vs-host disease, disease-free survival and overall survival, were similar between the two groups. In the univariate analysis, median costs for the first 100 days ($104 380 vs $42 149) and 1 year ($128 253 vs $80 499) in the HDCT group were higher than those in the RICT group. Median days of hospitalization are also higher for HDCT recipients (39 vs 21), although the number of outpatient clinic visits for HDCT recipients were fewer compared to that for RICT recipients (16 vs 25) during the first year. Adjusting for patient characteristics, RICT recipients had approximately 16 fewer days of hospitalization and cost $53 030 less than HDCT recipients within the first year after transplantation. Our data suggest that substantially lower costs and fewer days of hospitalization within the first year after RICT procedures can be obtained with no compromise of longterm clinical outcomes compared to HDCT procedures.