Costs of Peripheral Blood Progenitor Cell Transplantation Using Whole Blood Mobilised by Filgrastim as Compared With Autologous Bone Marrow Transplantation in Non-Hodgkin??s Lymphoma

Abstract

With the premise that both therapies are equivalent, it seems that whole blood transplantation is more cost effective than ABMT.

Granulocyte colony‐stimulating factor mobilized whole blood containing over 0·3 × 106/kg CD34+ cells is a sufficient graft in autologous transplantation for relapsed non‐Hodgkin's lymphoma

“…In this study, aimed at the feasibility of the WB procedure, a back‐up leukapheresis procedure was performed for all patients. If indeed it is possible to rescue all patients with 1 l of WB containing over 0·3 × 10 6 /kg, back‐up leukapheresis could be omitted, reducing average treatment costs by approximately 22% (Uyl‐de Groot et al , 1999). An alternative cost‐effective strategy could be to use the peripheral blood CD34 + cell count (which corresponds directly to the CD34 + cell count in 1 l of WB) at the time of collection to decide whether to proceed with WB or to collect PBSC via leukapheresis, instead of performing a back‐up leukapheresis for all patients.…”

“…A drawback of peripheral blood stem cells (PBSC) is the need for logistics and facilities for leukapheresis and cryopreservation, which makes it an expensive procedure. (Uyl‐de Groot et al , 1999).…”

Storage of unprocessed G-CSF-mobilized whole blood in a modified Leibovitz's L15 medium preserves clonogenic capacity for at least 7 days

“…A further reduction in costs can be achieved if, instead of leukapheresis, one liter of G-CSF primed whole blood (WB) is collected and re-infused unprocessed after high-dose chemotherapy. 2 Other advantages include the simplicity of the procedure and the low volume of blood involved. The latter could theoretically decrease the number of residual tumor cells in the transplant in comparison with a leukapheresis harvest, for which approximately 10 liters of blood is processed.…”

In vitro safety profile of G–CSF‐mobilized whole blood after storage for 7 days in an infusable‐grade L15 medium

“…G‐CSF‐mobilized whole blood (WB) is an easy‐to‐handle and cost‐attractive alternative for peripheral blood progenitor cells (PBPCs) obtained via leukapheresis to support high‐dose chemoradiotherapy in various malignant diseases 1‐5 . The two major disadvantages of the mobilized WB approach are the limited number of CD34+ cells that can be collected within 1 L and the limited storage time of a maximum of 72 hours.…”