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- Title
Autologous peripheral blood stem cell transplantation in patients with relapsed lymphoma results in accelerated haematopoietic reconstitution, improved quality of life and cost reduction compared with bone marrow transplantation: the Hovon 22 study.
- Authors
Vellenga, E.; van Agthoven, M.; Croockewit, A. J.; Verdonck, L. F.; Wijermans, P. J.; van Oers, M. H. J.; Volkers, C. P.; van Imhoff, G. W.; Kingma, T.; Uyl-de Groot, C. A.; Fibbe, W. E.
- Abstract
The present study analysed whether autologous peripheral blood stem cell transplantation (PSCT) improves engraftment, quality of life and cost-effectiveness when compared with autologous bone marrow transplantation (ABMT). Relapsing progressive lymphoma patients (n = 204; non-Hodgkin's lymphoma n = 166; Hodgkin's disease n = 38) were, after induction treatment with the DHAP–VIM (cisplatin, cytarabine, dexamethasone, etoposide, ifosfamide, methotrexate) regimen, randomly (2:1) assigned to the harvest of granulocyte–macrophage colony-stimulating factor-mobilized stem cells after the second DHAP course or autologous bone marrow cells before the second DHAP course. These stem cells were reinfused following high-dose myeloblative chemotherapy. After induction, 118 patients obtained a partial or complete response and were eligible for randomization. In the PSCT arm (n = 76) significantly faster engraftment of neutrophils [≥ 0·1 and ≥ 0·5 × 109/l: 10·7 d (7–36, median, range), 15 (9–45) versus 13 (8–25) and 26 (14–80), P < 0·01] and thrombocytes [≥ 20 × 109/l: 13 d (7–51) versus 18 (11–65), P < 0·01] were observed. In addition, significantly fewer transfusions of red blood cells [6 (0–23) versus 8 (2–24), P < 0·01] and platelets [4 (0–60) versus 8 (2–55), P = 0·01] were required in the PSCT arm. These findings were associated with a significant reduction in the median days of intravenous antibiotics in patients with fever [8·5 (0–30) versus 14 (0–34), P = 0·04] and hospital stay [27 (8–51) versus 34 (24–78), P < 0·05]. Quality of life demonstrated a significant difference in favour of the PSCT arm. Total transplantation costs were significantly lower in the PSCT arm [$13 954 ($4913– 29 532) versus $17 668 ($10 170–44 083) P <...
- Subjects
STEM cell transplantation; QUALITY of life; COST effectiveness; BONE marrow transplantation; LYMPHOMAS
- Publication
British Journal of Haematology, 2001, Vol 114, Issue 2, p319
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1046/j.1365-2141.2001.02926.x