Hematopoietic stem cell transplants for chronic myeloid leukemia in Europe—Impact of cost considerations

Gratwohl, Aloïs; Baldomero, Helen; Schwendener, Alvin; Gratwohl, Michael; Urbano-Ispizúa, Álvaro; Frauendorfer, Karl

doi:10.1038/sj.leu.2404509

Cited by 38 publications

(33 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As previously reported, transplant rates were similar for some indications between high-income and middle-income countries, for example, for chronic myeloid leukemia. 8 Compared with conventional modern drug treatment, which needs to be taken lifelong, HSCT might become more cost-effective as a once-in-a-lifetime procedure. As such, these data illustrate the need for more research into the mechanisms of technology diffusion.…”

Section: Discussionmentioning

confidence: 99%

Why are there regional differences in stem cell transplantation activity? An EBMT analysis

Gratwohl

Baldomero

Frauendorfer

et al. 2008

Bone Marrow Transplant

Self Cite

View full text Add to dashboard Cite

Differences in the number of hematopoietic SCTs (HSCT), in transplant rates, in indications and in techniques between countries have been reported. They were attributed mainly to differences in the economic situation of the countries or to differences in prevalences of the disease. On the basis of the results of the annual activity survey on HSCT of the European Blood and Marrow Transplantation (EBMT), we have analyzed the factors associated with differences between more than 600 teams participating from more than 40 countries over a time span of 15 years. The results show a more complex situation. The gross national income per capita, number of transplant teams per 10 million inhabitants or per 10 000 km 2 , team size and team experience all impact on transplant activity. Furthermore, hitherto unknown factors must add to the decisions to perform or not to perform HSCT. These data illustrate that more research is needed to understand the mechanism of HSCT activity and to enable health-care agencies to provide the necessary infrastructure.

show abstract

Section: Discussionmentioning

confidence: 99%

Why are there regional differences in stem cell transplantation activity? An EBMT analysis

Gratwohl

Baldomero

Frauendorfer

et al. 2008

Bone Marrow Transplant

Self Cite

View full text Add to dashboard Cite

show abstract

“…Transplant rates were primarily influenced, as previously shown, by the income of the countries with clear dependency from their GNI per capita. [14][15][16] Countries with high income, as defined by the World Bank, performed more transplants than countries with less income. The report highlights the increasing role of unrelated donors in allogeneic HSCT.…”

Section: Discussionmentioning

confidence: 99%

Results of the EBMT activity survey 2005 on haematopoietic stem cell transplantation: focus on increasing use of unrelated donors

Gratwohl

Baldomero

Frauendorfer

et al. 2007

Bone Marrow Transplant

Self Cite

100

View full text Add to dashboard Cite

This EBMT activity report documents the haematopoietic stem cell transplantation (HSCT) activity in Europe in 2005. It provides numbers of HSCT by indication, donor type and stem cell source, lists the new practice of planned double transplants with allogeneic after autologous HSCT and concentrates on the increasing role of unrelated transplants over the last years. In 2005, there were 24 168 first HSCT, 8890 allogeneic (37%), 15 278 autologous (63%) and 3773 additional re-or multiple transplants reported from 597 centres in 43 participating countries. Main indications were leukaemias (7404 (31%; 82% allogeneic)); lymphomas (13 825 (57%; 89% autologous)); solid tumours (1655 (7%; 92% autologous)) and non-malignant disorders (1131 (5%; 93% allogeneic)). A total of 671 planned allogeneic after autologous HSCT were reported; the majority for myeloma (52%), lymphoma (28%) and acute myeloid leukaemia (11%). Compared to 2004, there was a 20% increase in allogeneic HSCT; numbers of autologous HSCT remained constant. The most noticeable increase was in unrelated HSCT, which comprise 41% of all allogeneic HSCT. Unrelated HSCT were preferentially performed for leukaemias and in countries with high income according to World Bank criteria. These data illustrate the current experience in Europe and form the basis for patient counselling and decisions making at health care institutions.

show abstract

Section: Introductionmentioning

confidence: 99%

“…It is, however, a complex, resource-intense and costly procedure. [1][2][3][4] The cost of HSCT has been previously evaluated, mainly in the setting of HLA identical sibling 5 and matched unrelated donor transplants.The first studies on the cost-efficacy of HSCT compared allogeneic HSCT to chemotherapy in patients with acute leukemia. 7,8 Despite the high cost of HSCT, the results demonstrated the advantages of the procedure due to the impact on long-term survival adjusted to the quality of life.…”

mentioning

confidence: 99%

Cost-effectiveness and clinical outcomes of double versus single cord blood transplantation in adults with acute leukemia in France

Labopin¹,

Ruggeri²,

Gorin³

et al. 2013

Haematologica

View full text Add to dashboard Cite

IntroductionAllogeneic stem cell transplantation (HSCT) is effective treatment for patients with various hematologic disorders. It is, however, a complex, resource-intense and costly procedure. [1][2][3][4] The cost of HSCT has been previously evaluated, mainly in the setting of HLA identical sibling 5 and matched unrelated donor transplants.The first studies on the cost-efficacy of HSCT compared allogeneic HSCT to chemotherapy in patients with acute leukemia. 7,8 Despite the high cost of HSCT, the results demonstrated the advantages of the procedure due to the impact on long-term survival adjusted to the quality of life. In the first published studies, the estimated costs for HSCT varied greatly (Online Supplementary Table S1) depending on the country in which they were performed, type of donor, transplant center procedures and year of transplantation. 5,7,[9][10][11] A more recent comparative study of autologous and allogeneic HSCT for patients transplanted for hematologic malignancies in the USA estimated a 100-day total cost of US$ 203,026 for allogeneic HSCT. 12 Unrelated donor cord blood transplantation (UCBT) has become a widely accepted transplant modality in the absence of an HLA-matched donor. [13][14][15][16] However, the delay of engraftment and the increased risk of graft failure remain problems in adults transplanted with a single cord blood unit. The possibility of using two cord blood units has extended the use of UCBT to patients for whom a single unit containing a minimum of 2.5x10 7 /kg total nucleated cells is not available. [17][18][19] Studies have been performed comparing outcomes after single (s) UCBT and double (d) UCBT,20 but, none focused on a homo- open-access paper. doi:10.3324/haematol.2013.092254 The online version of this article has a Supplementary Appendix. Manuscript received on May 27, 2013. Manuscript accepted on October 14, 2013 Double cord blood transplantation extends the use of cord blood to adults for whom a single unit is not available, but the procedure is limited by its cost. To evaluate outcomes and cost-effectiveness of double compared to single cord blood transplantation, we analyzed 134 transplants in adults with acute leukemia in first remission. Transplants were performed in France with reduced intensity or myeloablative conditioning regimens. Costs were estimated from donor search to 1 year after transplantation. A Markov decision analysis model was used to calculate qualityadjusted life-years and cost-effectiveness ratio within 4 years. The overall survival at 2 years after single and double cord blood transplants was 42% versus 62%, respectively (P=0.03), while the leukemia-free-survival was 33% versus 53%, respectively (P=0.03). The relapse rate was 21% after double transplants and 42% after a single transplant (P=0.006). No difference was observed for non-relapse mortality or chronic graft-versus-host-disease. The estimated costs up to 1 year after reduced intensity conditioning for single and double cord blood transplantation were € 165,253 and €191,...

show abstract

Hematopoietic stem cell transplants for chronic myeloid leukemia in Europe—Impact of cost considerations

Cited by 38 publications

References 27 publications

Why are there regional differences in stem cell transplantation activity? An EBMT analysis

Why are there regional differences in stem cell transplantation activity? An EBMT analysis

Results of the EBMT activity survey 2005 on haematopoietic stem cell transplantation: focus on increasing use of unrelated donors

Cost-effectiveness and clinical outcomes of double versus single cord blood transplantation in adults with acute leukemia in France

Contact Info

Product

Resources

About