Effect of lenograstim on the cost of autologous bone marrow transplantation. A preliminary communication.

High dose chemotherapy and autologous bone marrow transplantation (BMT) can produce prolonged remission in patients with malignant lymphoma or solid tumours. However, neutropenia is a serious complication of treatment in patients with these diseases. In this study, we investigated the costs and effects of using lenograstim, a recombinant human granulocyte colony-stimulating factor, to treat neutropenia in 16 patients with lymphoma or solid tumours. The cost of lenograstim was not included in the calculations. The duration of neutropenia and hospitalisation were both lower in patients who received lenograstim compared with no treatment. The mean cost of autologous BMT was FF142,000 in patients who received lenograstim, compared with FF166,000 in patients who did not. Savings were largely attributable to decreased expenditure on hospitalisation in the lenograstim-treated group. The cost of 14 days' treatment with lenograstim was estimated at FF10,500, based on a daily dosage of 150 micrograms/m2/day.

[Influence of the granulocyte growth factor on the cost of bone marrow autografts in oncologic hematology]. / Influence du facteur de croissance granulocytaire sur le coût des autogreffes de moelle en onco-hématologie.

OBJECTIVE: It is now possible to achieve prolonged remission of malignant lymphoma and certain cancers with high-dose chemotherapy followed by autograft with haematopoietic stem cells. We tested such a protocol, evaluating haematologic recovery, in order to determine the total cost of hospitalization. METHODS: Sixteen patients were included in the study, 7 had severe or relapsing lymphoma, 7 had breast cancer or cancer of the ovary and 2 had cancer of the testicule. Mean age was 34 years, 14 patients reached complete remission and relapse occurred in 2. Ten patients were given granulocyte growth factor and 6 were given a placebo. RESULTS: The duration of aplasia (number of days with a white cell count below 1 x 10(9)1) ranged from 10 to 32 days. In patients treated with granulocyte growth factor, it was shorter (16 vs 22 days) as was hospitalization time (27 vs 33 days). The cost of the autograft ranged from 100,000 FF to 250,000 FF and the average cost for the 16 patients was 149,500 FF including: 83,600 FF (56.4%) for hospitalization itself, 33,200 FF (22%) for drugs, mostly antibiotics, and 19,000 FF (13%) for laboratory examinations and 14,000 FF (9%) for blood transfusions. Total cost was lower in patients given granulocyte growth factor, 142,000 FF vs 166,000 FF for those given placebo. CONCLUSION: In order to shorten the duration of the aplasia period, haematopoietic growth factors are widely used in autograft protocols. Our findings give an evaluation of the cost in 16 patients and show that cost decreases in patients given granulocyte growth factor. This reduction is cost is related to a lower hospitalization cost and not a reduction in the number of drugs and transfusions required.

Use of the Kaufman-Assessment Battery for Children with the hearing impaired.

The Kaufman-Assessment Battery for Children (K-ABC), a measure of cognitive functioning, was administered to 26 male and 24 female hearing-impaired elementary school students to determine its appropriateness for hearing-impaired children. The Wechsler Intelligence Scale for Children-Revised (WISC-R) also was administered. Scores for the present hearing-impaired sample on the K-ABC were compared with the normative group and were correlated with the WISC-R and standard achievement test scores. Results showed that both the Simultaneous Processing Scale and the Nonverbal Scale seemed appropriate for hearing-impaired children, whose scores were similar to those of the test's normative sample. Scores on the K-ABC also correlated highly with scores from the WISC-R. The Sequential Processing Scale was more problematic and not as useful. The K-ABC was significantly related to school achievement. Difficulties in the administration of the instrument with hearing-impaired children also are discussed.