Comparative cost of allogeneic or autologous bone marrow transplantation and chemotherapy in patients with acute myeloid leukaemia in first remission.

We compared the direct costs of allogeneic bone marrow transplantation (Allo-BMT), autologous bone marrow transplantation (Auto-BMT) and chemotherapy (Chemo) in 40 adult patients under the age of 55 years with acute myeloid leukaemia (AML) in first complete remission (CR). Fourteen patients were treated with Allo-BMT, 11 with Auto-BMT and 15 with Chemo. These patients, who were part of two cooperative consecutive trials enrolling a total of 196 patients (BGM 84 and BGMT 87 studies), were those who were treated in the CHR Bordeaux and achieved CR after induction chemotherapy. Cost accounting extended over a maximum period of 5 years. The average cost of the procedure for a mean follow-up of 2 years and excluding the cost of treatment after relapse which eventually occurred was significantly higher for the Allo-BMT group (FF 392,724) and the Auto-BMT group (FF 393,461) than for the group that received Chemo (FF 128,947) (p < 0.00001). The average cost for the treatment of relapse was estimated at FF 266,436, irrespective of the previous treatment. The total cost, including the estimated cost of relapse according to its probability of occurring calculated from the original population, was significantly higher for the Allo-BMT group (FF 424,696; p < 0.01) and the Auto-BMT group (FF 505,364; p < 0.0001) than for the Chemo group (FF 304,846).(ABSTRACT TRUNCATED AT 250 WORDS)