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Cost-Effectiveness of Allogeneic Peripheral Blood Stem Cell Transplantation versus Bone Marrow Transplantation in Pediatric Acute Leukemia

Strategic Insights

— 2 min read

A recent report published in Biology of Blood and Marrow Transplantation presents fresh data on the cost-effectiveness of allogeneic peripheral blood stem cell transplantation (PBSCT) versus bone marrow transplantation (BMT) in pediatric patients with acute leukemia. Researchers from the United States conducted a retrospective study evaluating the cost and cost-effectiveness of PBSCT and BMT in children with acute leukemia after 1 year of follow-up. The study found that treatment success rates varied between the two groups, with BMT recipients experiencing a higher success rate in the standard-risk disease group and a similar success rate in the high-risk disease group. However, BMT was found to be more costly than PBSCT in both groups, with a cumulative average cost of $352,885 for BMT recipients in the standard-risk disease group and $457,078 in the high-risk disease group.

Key Takeaways:

  • The treatment success rate for standard-risk disease was 57.1% for PBSCT recipients and 80.3% for BMT recipients, with a non-significant difference (p=NS).
  • The average total cost per treatment success at 1 year in the standard-risk disease group was $512,294 for PBSCT recipients and $352,885 for BMT recipients, with a non-significant difference (p=NS).
  • For patients with high-risk disease, the treatment success rate was 18.8% for PBSCT recipients and 23.5% for BMT recipients, with a non-significant difference (p=NS).
  • The cumulative average cost was $377,316 in PBSCT recipients and $457,078 in BMT recipients, with a non-significant difference (p=NS).
  • Point estimates of the incremental cost-effectiveness ratio (ICER) indicated that allogeneic BMT had a lower cost and greater effectiveness than PBSCT in standard-risk disease, with an ICER of -$687,108 (95% CI, $2.4 million to dominated).
  • In high-risk disease, BMT was more effective and more costly, with an ICER of $1.69 million (95% CI, $29.7 million to dominated) per additional treatment success.
  • More studies using larger and randomized controlled trials are needed to confirm the long-term cost-effectiveness of each procedure.

Statistics:

  • The study included 30 patients in the PBSCT group and 110 patients in the BMT group.
  • The treatment success rate for standard-risk disease was 80.3% for BMT recipients and 57.1% for PBSCT recipients.
  • The average total cost per treatment success at 1 year in the standard-risk disease group was $512,294 for PBSCT recipients and $352,885 for BMT recipients.
  • The cumulative average cost was $377,316 in PBSCT recipients and $457,078 in BMT recipients.
  • The ICER for standard-risk disease was -$687,108 (95% CI, $2.4 million to dominated) for BMT recipients.
  • The ICER for high-risk disease was $1.69 million (95% CI, $29.7 million to dominated) per additional treatment success.

Sources:

  • Lin Y.F., et al. (2010). The costs and cost-effectiveness of allogeneic peripheral blood stem cell transplantation versus bone marrow transplantation in pediatric patients with acute leukemia. Biology of Blood and Marrow Transplantation, 2010; 16(9), 1272-81.

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