Hematopoietic growth factors have shown clinical benefits in patients undergoing chemotherapy and stem cell transplantation, but few studies have been performed to assess whether the benefits are worth the costs.
We reviewed 196 patients undergoing T-cell depleted related donor bone marrow transplantation (BMT) between 1990 and 1996 to assess the effect of growth factor use on time to engraftment and costs of hospitalization.
Beginning in 1994, based on encouraging results in autologous transplantation, patients In=81) were treated with granulocyte colony-stimulating factor (G-CSF) starting at day+1 after marrow infusion until engraftment.
Between January 1,1990 and January 1,1994, patients In=115) did not receive growth factor.
CD6 depletion of donor marrow was the only form of prophylaxis against graft-versus-host disease (GVHD).
Despite receiving a lower stem cell dose (P=004), the group receiving G-CSF had a decreased time to engraftment (20 days v 12 days, P<. 0001) and time from marrow infusion to discharge (23 days v 17 days, P<. 0001).
In multivariate modeling, the use of G-CSF was the most significant factor predicting time to engraftment and discharge.
Incidence of grades Il-IV GVHD, early mortality, percentage of patients who engrafted, and relapse rates did not differ between the groups. (...)
Mots-clés Pascal : Hémopathie maligne, Homogreffe, Moelle osseuse, Lymphocyte T, Déplétion, Prise greffe, Facteur stimulant colonie granulocyte, Traitement, Efficacité traitement, Analyse coût, Economie santé, Hospitalisation, Homme, Cytokine, Polypeptide
Mots-clés Pascal anglais : Malignant hemopathy, Homograft, Bone marrow, T-Lymphocyte, Depletion, Engraftment, Granulocyte colony stimulating factor, Treatment, Treatment efficiency, Cost analysis, Health economy, Hospitalization, Human, Cytokine, Polypeptide
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0500014
Code Inist : 002B27D02. Création : 19/02/1999.