Abstract：
BACKGROUND: Allogeneic haematopoietic stem cell transplantation (HSCT) is increasingly used, but this treatment is complex and costly. As clinical outcomes of HSCT with matched unrelated donor (MUD) and haploidentical donors are similar, costs could influence donor choice.
METHODS: We retrospectively compared resource utilisation and costs of HSCT using the three different donor types (matched related donor (MRD) (n = 32), haploidentical related (n = 30) and MUD (n = 60)) within the first year after transplantation. Costs were analysed through a bottom-up method. Non-parametric bootstrapping was applied to test for statistical differences in costs. Subgroup analyses were performed to identify predictors for costs.
RESULTS: Cost pre-transplant for search and acquisition of the graft were significantly higher in MUD HSCT (€35 222) versus MRD and haploidentical HSCT (€15 356 and €16 097 respectively). The costs of haploidentical HSCT were the highest in the transplant phase. Main cost factors were inpatient days and medication. Overall, the costs for haploidentical and MUD HSCT were similar (€115 724 for MUD, €113 312 for haploidentical).
CONCLUSIONS: Our study suggests no difference in total transplantation costs between allogeneic HSCT using a MUD or a haploidentical donor. Since clinical outcomes seem similar as well, the choice of donor type might be based on availability, speed and logistics.
METHODS: We retrospectively compared resource utilisation and costs of HSCT using the three different donor types (matched related donor (MRD) (n = 32), haploidentical related (n = 30) and MUD (n = 60)) within the first year after transplantation. Costs were analysed through a bottom-up method. Non-parametric bootstrapping was applied to test for statistical differences in costs. Subgroup analyses were performed to identify predictors for costs.
RESULTS: Cost pre-transplant for search and acquisition of the graft were significantly higher in MUD HSCT (€35 222) versus MRD and haploidentical HSCT (€15 356 and €16 097 respectively). The costs of haploidentical HSCT were the highest in the transplant phase. Main cost factors were inpatient days and medication. Overall, the costs for haploidentical and MUD HSCT were similar (€115 724 for MUD, €113 312 for haploidentical).
CONCLUSIONS: Our study suggests no difference in total transplantation costs between allogeneic HSCT using a MUD or a haploidentical donor. Since clinical outcomes seem similar as well, the choice of donor type might be based on availability, speed and logistics.
摘要：
背景：异基因造血干细胞移植（HSCT）的应用日益广泛，但是这种治疗是复杂且昂贵的。由于HSCT与匹配的无关供体（MUD）和单倍体供体的临床结果相似，成本可能会影响捐赠者的选择。
方法：我们使用三种不同的供体类型（匹配相关供体（MRD）（n=32））对HSCT的资源利用率和成本进行了回顾性比较。移植后第一年内单倍体相关（n=30）和MUD（n=60）。通过自下而上的方法分析了成本。非参数自举用于测试成本的统计差异。进行亚组分析以确定成本的预测因子。
结果：MUDHSCT（35.222欧元）与MRD和单倍体HSCT（分别为15.356欧元和16.097欧元）相比，移植前用于搜索和获取移植物的成本显着提高。单倍体HSCT的成本在移植阶段最高。主要费用因素是住院天数和用药。总的来说,单倍体和MUDHSCT的费用相似(MUD为115.724欧元，单倍体113.312欧元)。
结论：我们的研究表明，使用MUD或单倍体供体的同种异体HSCT之间的总移植成本没有差异。由于临床结果似乎也相似，捐赠者类型的选择可能基于可用性，速度和物流。
方法：我们使用三种不同的供体类型（匹配相关供体（MRD）（n=32））对HSCT的资源利用率和成本进行了回顾性比较。移植后第一年内单倍体相关（n=30）和MUD（n=60）。通过自下而上的方法分析了成本。非参数自举用于测试成本的统计差异。进行亚组分析以确定成本的预测因子。
结果：MUDHSCT（35.222欧元）与MRD和单倍体HSCT（分别为15.356欧元和16.097欧元）相比，移植前用于搜索和获取移植物的成本显着提高。单倍体HSCT的成本在移植阶段最高。主要费用因素是住院天数和用药。总的来说,单倍体和MUDHSCT的费用相似(MUD为115.724欧元，单倍体113.312欧元)。
结论：我们的研究表明，使用MUD或单倍体供体的同种异体HSCT之间的总移植成本没有差异。由于临床结果似乎也相似，捐赠者类型的选择可能基于可用性，速度和物流。
