Faucher C, Fortanier C, Viens P, Le Corroller A G, Chabannon C, Camerlo J, Novakovitch G, Gastaut J A, Maraninchi D, Moatti J P, Blaise D
Institut Paoli-Calmettes, Regional Center for Cancer Research and Treatment, Marseille, France.
Bone Marrow Transplant. 1998 Jun;21 Suppl 3:S92-8.
The study presented is a clinical and economic comparison of bone marrow (BM) and blood cells (BC) allogeneic transplantation. We performed a case-control study to compare 17 patients receiving allogeneic BC transplant in a pilot study to an historical group of 17 patients allografted with BM. We evaluated the clinical outcomes and the direct medical costs of transplantation from conditioning regimen until day 100 by detailed observation of patients' medical records. Patients in the BC group received a median of 8 x 10(6)/kg CD34+ cells (1.58-29.1) and 266 x 10(6)/kg CD3+ cells (128-469). All patients had neutrophil engraftment with a median of 14 days in the BC group vs 19 days in the BM group (P < 0.05). The Kaplan-Meier estimation of the median number of days to a platelet count of > 25 x 10(9)/l, independent of platelet transfusion, was significantly shorter in the BC group (15 (9-74)) compared with the BM group (25 (15-45)). Acute graft-versus-host disease (AGVHD) of grade > or = 2 was not significantly different between the two groups. Patients treated with BC presented a US$16,134 decrease in the cost of the first 100 days (29%, P = 0.006). Our comparison suggested that platelet reconstitution and total costs were in favor of the BC group.
本研究是对骨髓（BM）和血细胞（BC）同种异体移植进行临床和经济学比较。我们进行了一项病例对照研究，将17例在一项初步研究中接受同种异体BC移植的患者与17例接受BM同种异体移植的历史对照组进行比较。我们通过详细观察患者的病历，评估了从预处理方案到第100天的移植临床结果和直接医疗费用。BC组患者接受的CD34+细胞中位数为8×10⁶/kg（1.58 - 29.1），CD3+细胞中位数为266×10⁶/kg（128 - 469）。所有患者均实现中性粒细胞植入，BC组的中位数为14天，而BM组为19天（P < 0.05）。在不依赖血小板输注的情况下，血小板计数> 25×10⁹/L的天数中位数的Kaplan - Meier估计值在BC组（15（9 - 74））显著短于BM组（25（15 - 45））。两组间≥2级的急性移植物抗宿主病（AGVHD）无显著差异。接受BC治疗的患者前100天的费用降低了16,134美元（29%，P = 0.006）。我们的比较表明，血小板重建和总成本对BC组有利。
