Autologous stem cell transplantation in the treatment of cancer

A clinical and economic evaluation of red blood cell transfusions in patients receiving cancer chemotherapy

A clinical and economic evaluation of red blood cell (RBC) utilization in cancer patients during chemotherapy is described. Using a randomized sampling process, 100 patients who had received chemotherapy with or without cisplatin were selected (50 in each group). Multiple logistic regression was then used to identify risks factors for transfusion requirements. Twenty-five percent of patients in the cisplatin and 12% in the noncisplatin group received at least one blood transfusion during chemotherapy (p = .09). Depressed hemoglobin levels and cisplatin dosage were identified as risk factors for transfusion requirements. Combining all transfused patients revealed an overall cost of Can $599 (95% CI: $513-$683) per transfusion. The results of the current study indicated that anemia is a common complication of cancer chemotherapy that can be costly to manage.

Cytapheresis--the next 25 years: stem cell therapy

Hemopoietic stem cell transplantation therapy has firmly established a role in the management of a range of malignant and nonmalignant disorders. Allogeneic bone marrow transplantation has been used as an adjunct in the treatment of acute leukemia with impressive results that have translated into long-term survival and cure. This experience has now extended to the management of other hematological malignancies and some solid tumors. With the ability to source hemopoietic stem cells from the peripheral blood by in vivo cytapheresis, there has been a rapid growth in the use of this form of therapy. The risks and benefits must be clearly appreciated and appropriate resources available with associated monitoring and quality assurance. There are few areas of medicine for which such close cooperation is necessary between medical, nursing, scientific, and allied health professionals to achieve successful outcomes. This paper addresses the logistical aspects of the provision of hemopoietic stem cell therapy in a routine clinical setting.