PMID- 12351374
OWN - NLM
STAT- MEDLINE
DCOM- 20021205
LR  - 20210206
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 100
IP  - 8
DP  - 2002 Oct 15
TI  - Comparison of T-cell-depleted and non-T-cell-depleted unrelated donor 
      transplantation for hematologic diseases: clinical outcomes, quality of life, and 
      costs.
PG  - 2697-702
AB  - T-cell depletion (TCD) and immunosuppressive medications (ISTs) are 2 methods 
      used for graft-versus-host disease (GVHD) prophylaxis in unrelated donor (URD) 
      transplantation. However, comparisons of the clinical outcomes including quality 
      of life and direct medical costs associated with each type of procedure have not 
      been reported. We reviewed 48 TCD and 98 IST procedures performed from 1/1/97 to 
      12/31/99 at the Dana-Farber Cancer Institute, Boston, MA. With a median follow-up 
      of 1.5 years for survivors, no differences were seen in relapse, acute GVHD, and 
      overall survival between TCD and IST patients. Multivariable Cox modeling showed 
      that age of 50 years or less (P =.002) and low-risk disease (P =.001) predicted 
      survival, but method of GVHD prophylaxis (P =.6) and degree of human leukocyte 
      antigen (HLA) matching (P =.8) did not. A subset of patients (53%) completed 
      quality of life surveys prior to and at 6 and 12 months after transplantation; 
      participation in the quality of life study was not associated with clinical 
      characteristics and outcomes. No differences were seen in quality of life scores 
      prior to transplantation, and changes over time were similar between groups. 
      Costs ($113 000 vs $155 000, P <.0001) and total hospital days (34 vs 46, P 
      =.0006) were significantly lower for patients undergoing TCD procedures. As 
      prospective, randomized studies comparing methods of GVHD prophylaxis are 
      performed, assessment of quality of life and costs should be included to fully 
      understand the overall impact of each intervention.
FAU - Lee, Stephanie J
AU  - Lee SJ
AD  - Department of Adult Oncology and Department of Biostatistical Science, 
      Dana-Farber Cancer Institute, and the Department of Medicine, Brigham and Women's 
      Hospital, Boston, MA 02115, USA. stephanie_lee@dfci.harvard.edu
FAU - Zahrieh, David
AU  - Zahrieh D
FAU - Alyea, Edwin P
AU  - Alyea EP
FAU - Weller, Edie
AU  - Weller E
FAU - Ho, Vincent T
AU  - Ho VT
FAU - Antin, Joseph H
AU  - Antin JH
FAU - Soiffer, Robert J
AU  - Soiffer RJ
LA  - eng
GR  - AI29530/AI/NIAID NIH HHS/United States
GR  - CA75267/CA/NCI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Bone Marrow Transplantation/economics/mortality/*physiology
MH  - Boston
MH  - Cause of Death
MH  - Costs and Cost Analysis
MH  - Female
MH  - Follow-Up Studies
MH  - Graft vs Host Disease/economics/epidemiology
MH  - Hematologic Diseases/economics/mortality/*therapy
MH  - Hematologic Neoplasms/economics/immunology/mortality/*therapy
MH  - Humans
MH  - Immunosuppressive Agents/economics/*therapeutic use
MH  - Lymphocyte Depletion/*economics
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Proportional Hazards Models
MH  - Quality of Life
MH  - Recurrence
MH  - Retrospective Studies
MH  - Survival Analysis
MH  - T-Lymphocytes/*immunology
MH  - Time Factors
MH  - Transplantation Immunology
MH  - Treatment Outcome
EDAT- 2002/09/28 04:00
MHDA- 2002/12/06 04:00
CRDT- 2002/09/28 04:00
PHST- 2002/09/28 04:00 [pubmed]
PHST- 2002/12/06 04:00 [medline]
PHST- 2002/09/28 04:00 [entrez]
AID - S0006-4971(20)50926-9 [pii]
AID - 10.1182/blood-2002-03-0984 [doi]
PST - ppublish
SO  - Blood. 2002 Oct 15;100(8):2697-702. doi: 10.1182/blood-2002-03-0984.