Le Corroller A G, Macquart-Moulin G, Auquier P, Faucher C, Chabannon C, Blache J L, Blaise D, Novakovitch G, Maraninchi D, Moatti J P
INSERM, Unité 379, Institut Paoli-Calmettes, Marseille.
Rev Epidemiol Sante Publique. 1996 Apr;44(2):133-43.
The aim of this study, carried out at the Institut Paoli-Calmettes (Marseille-France), was to compare, in terms of monetary and non monetary costs, alternate procedures for hematopoietic stem cells collection i.e. peripheral blood stem cells collection (PBSCC) and bone marrow collection (BMC) used in cancer therapies. Monetary costs have been evaluated by calculating the direct costs of the two types of procedures and non monetary costs by comparing anxiety, discomfort and pain of cancer patients submitted to PBSCC or BMC. Patients, randomized (7/1993-2/1994), in view of autologous transplantation, to receive the first procedure or the second one received three self-administered questionnaires to complete before, during and after the procedure. Pain was assessed using visual analogical scale and McGill Pain questionnaire. Anxiety was evaluated by means of State-Trait Anxiety Inventory. Results showed that, under some conditions, presently realized in the current practice, direct costs of PBSCC (10,140 to 13,780 FF) were lower than BMC ones (16,509 FF) and that anxiety and pain experienced by patients submitted to PBSCC, with or without femoral catheter, were significantly less severe than in other group patients (State anxiety, before procedure : p < 0.01 ; pain related to the procedure assessed on VAS : p < 0.001 and total McGill score : p < 0.00001). These findings justify the substitution of bone marrow transplantation by peripheral blood stem cells transplantation, provided there is a demonstration of similar medical efficacy for cancer therapy.
这项在法国马赛的保罗 - 卡美特研究所开展的研究旨在比较癌症治疗中造血干细胞采集的两种替代程序，即外周血干细胞采集（PBSCC）和骨髓采集（BMC）在货币成本和非货币成本方面的差异。通过计算两种程序的直接成本来评估货币成本，通过比较接受PBSCC或BMC的癌症患者的焦虑、不适和疼痛来评估非货币成本。1993年7月至1994年2月，鉴于自体移植，随机安排患者接受第一种程序或第二种程序，并在程序前、程序中和程序后填写三份自我管理的问卷。使用视觉模拟量表和麦吉尔疼痛问卷评估疼痛。通过状态 - 特质焦虑量表评估焦虑。结果表明，在当前实践中的某些条件下，PBSCC的直接成本（10,140至13,780法郎）低于BMC的成本（16,509法郎），并且接受PBSCC的患者，无论有无股静脉导管，所经历的焦虑和疼痛明显轻于其他组患者（程序前状态焦虑：p < 0.01；VAS评估的与程序相关的疼痛：p < 0.001；麦吉尔总分：p < 0.00001）。这些发现表明，如果能证明外周血干细胞移植在癌症治疗方面具有与骨髓移植相似的医学疗效，那么用外周血干细胞移植替代骨髓移植是合理的。
