LOS ANGELES--An economic analysis has shown that use of filgrastim(Drug information on filgrastim)-primed peripheral blood progenitor cells (PBPCs) in relapsed lymphoma patients undergoing high-dose chemotherapy is significantly less expensive than autologous bone marrow transplantation (ABMT), Thomas J. Smith, MD, said at the American Society of Clinical Oncology (ASCO) annual meeting.
The total cost of treatment was 31% less using PBPCs primed with filgrastim (G-CSF, Neupogen). "It is rare in this day and age to find a procedure that is not only more effective but also more cost effective," said Dr. Smith, of the Medical College of Virginia, Massey Cancer Center, Richmond.
The economic study was based on data from a prospective randomized clinical trial performed at seven centers in four European countries. This trial compared the two transplant methods in 72 patients with relapsed Hodgkin's disease or non-Hodgkin's lymphoma (37 randomized to receive PBPC and 35 to receive ABMT). Peripheral blood progenitor cells were collected after mobilization by filgrastim.
In this trial, patients who received filgrastim-primed PBPC support had significantly shorter hospital stays than those in the ABMT arm (20 days vs 26 days, respectively); faster time to neutrophil recovery (13 days vs 15 days); faster time to platelet recovery (20 days vs 27 days); and fewer platelet transfusions (5 vs 12). Exposure to blood products (and risk of HIV or hepatitis) was markedly less in the filgrastim-primed PBPC patients. There was no difference in safety between the two procedures, with one treatment-related death on each arm.
The total estimated cost of treatment for the filgrastim-primed PBPC patients was about $40,000, compared with $58,000 for the ABMT group. The $18,000 savings resulted primarily from reduced hospitalization.
"The PBPC patients were out of the hospital an average of about a week sooner," Dr. Smith said. He added that the savings far exceeded the costs of filgrastim priming and PBPC collection.
