Abstract
As part of an NHS Executive Trent regional initiative we considered the role and cost-effectiveness of high dose chemotherapy in the treatment of relapsed Hodgkin’s disease and non-Hodgkin’s lymphoma. The key trials and case series show an additional patient benefit of 0.8–1.1 life years over standard chemotherapy. We estimate incremental cost per life year gained of £12 800–£17 600, which reduces further if long-term benefits are considered. High dose chemotherapy in these conditions is both life-saving and cost-effective. © 2000 Cancer Research Campaign
Similar content being viewed by others
Article PDF
Change history
16 November 2011
This paper was modified 12 months after initial publication to switch to Creative Commons licence terms, as noted at publication
References
Beard SM, Lorigan P, Sampson F and Sims A (1998) The effectiveness of high dose chemotherapy with autologous stem cell transplantation in the treatment of Hodgkin’s disease and non-Hodgkin’s lymphoma, Sheffield, Trent Institute for Health Services Research, Universities of Leicester, Nottingham and Sheffield. Guidance Note for Purchasers: 98/04
Bierman PJ, Bagin RG and Jagannath S (1993) High-dose chemotherapy followed by autologous hematopoietic rescue in Hodgkin’s disease: long-term follow-up in 128 patients. Ann Oncol 4: 767–773
Chopra R, McMillan AR and Linch DC (1993) The place of high dose BEAM therapy with autologous bone marrow transplantation in poor risk Hodgkin’s disease: a single centre 8-year study of 155 patients. Blood 81: 1137–1145
Department of Health (1998). A first class service – quality in the new NHS, Department of Health: London
Goldman JM, Schmits N, Niethammer D and Gratwohl A (1998) Allogeneic and autologous transplantation for haematological diseases, solid tumours and immune disorders: current practice in Europe in 1998. Bone Marrow Transpl 21: 1–7
Goldstone AH and McMillan AK (1993) The place of high-dose therapy with haemopoietic stem cell transplantation in relapsed and refractory Hodgkin’s disease. Ann Oncol supp 1: S21–S27
Hancock BW and Barber A (1995) The cost effectiveness of cancer chemotherapy: a clinicians view. Proc R Coll Physic Edinburgh 25: 61–66
Johnson PWM, Simnett SJ and Sweetenham JW (1998) Bone marrow and peripheral blood stem cell transplantation for malignancy. Health Technol Assess 2: 8
Linch DC, Winfield D and Goldstone AH (1993) Dose intensification with autologous bone marrow transplantation in relapsed and resistant Hodgkin’s disease: results of a BNLI randomised trial. Lancet 34: 1051–1054
Longo DL, Duffy PL and Young RC (1992) Conventional dose salvage combination chemotherapy in patients relapsing with Hodgkin’s disease after combination chemotherapy: the low probability of cure. J Clin Oncol 10: 210–218
NHS Management Executive (1993) Costs for Contracting. FDL, (93). 59 Department of Health
Philip T, Chauvin F, Armitage J and Bran D (1991) PARMA International Protocol: pilot study of DHAP followed by involved field radiotherapy and high dose chemotherapy with autologous bone marrow transplantation. Blood 77: 1587–1592
Philip T, Gulglielmi C and Hagenbeek A (1995) Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemosensitive non-Hodgkin’s lymphoma. N Engl J Med 33: 1540–1545
Philip T, Gomez F and Guglielmi G (1998) Long-term outcome of relapsed non-Hodgkin’s lymphoma (NHL) patients included in the PARMA trial: incidence of late relapses, long-term toxicity and impact of the international prognostic index (IP) at relapse. Proc Am Soc Clin Oncol 17: A62
Reece DE, Barnett MJ and Connors JM (1991) Intensive chemotherapy with cyclophosphamide, carmustine and etoposide followed by autologous bone marrow transplantation for relapsed Hodgkin’s disease. J Clin Oncol 9: 1871–1879
Salzman DE, Briggs AD and Vaughan WP (1997) Bone marrow transplantation for non-Hodgkin’s lymphoma: a review. Am J Med Sci 313: 228–235
Schmitz N, Sextro M and Pfistner B, et al (1999) High dose therapy followed by haematopoietic stem cell transplantation for relapsed chemosensitive Hodgkin’s disease: final results of a randomised GHSG and EBMT trial (HD-R1). Available from internet at: http://asco/infostreet.com/prof/httml/99abstracts/all/m_5.htm
Stevens A, Colin-Jones D and Gabbay J (1995) ‘Quick and clean’: authoritative health technology assessment for local health care contracting. Health Trends 27: 37–42
Weisdorf DJ, Anderson JW and Glick JH (1992) Survival after relapse of low grade non-Hodgkin’s lymphoma: implications for marrow transplantation. J Clin Oncol 10: 942–947
Author information
Authors and Affiliations
Rights and permissions
From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/
About this article
Cite this article
Beard, S., Lorigan, P. & Sampson, F. The cost-effectiveness of high dose chemotherapy in the treatment of relapsed Hodgkin’s disease and non-Hodgkin's lymphoma. Br J Cancer 82, 81–84 (2000). https://doi.org/10.1054/bjoc.1999.0880
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1054/bjoc.1999.0880