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The economic cost of care in poor graft function following allogeneic stem cell transplantation

Bone Marrow Transplantation volume 60, pages 97–99 (2025)Cite this article

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Allogeneic stem cell transplantation (alloSCT) is a potentially curative treatment for diseases including myelodysplastic syndrome, leukaemia and lymphoma. However, the cost and resource requirements of alloSCT is significant, totalling to in excess of $250,000USD in the United States [1, 2].

Poor graft function (PGF), defined as multilineage cytopenias in the presence of complete donor chimerism, is a significant complication of alloSCT [3]. The incidence of PGF is estimated to vary between 5–11% of patients receiving alloSCT, depending on factors including donor type, conditioning regimen and underlying disease [4, 5]. Those afflicted by PGF are reliant on extended supportive care until marrow recovery and have significantly lower overall survival [5]. We have previously explored the bone marrow pathologies that potentiate PGF namely: (1) the quality and quantity of donor haematopoietic stem cells; (2) the residual bone marrow microenvironment following conditioning and; (3) immune dysfunction persisting following transplant [6]. However, the impact of PGF on cumulative healthcare costs has not previously been examined.

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Fig. 1: Discordance in burden of care between patients with poor graft function and good graft function.

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Acknowledgements

The authors are grateful to the costing teams at Royal Melbourne Hospital (Mr Jeffrey Ong) and Peter MacCallum Cancer Centre (Ms Josine Briones, Mr Sebastian Dubrovsky) who extracted data for this investigation.

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Authors and Affiliations

  1. Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC, Australia

    Manu Juneja, Ashvind Prabahran, Mayani Rawicki, Lynette C. Y. Chee & David S. Ritchie

  2. ACRF Translational Research Laboratory, The Royal Melbourne Hospital, Parkville, VIC, Australia

    Ashvind Prabahran, Mayani Rawicki, Lynette C. Y. Chee, Rachel M. Koldej & David S. Ritchie

  3. Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia

    Ashvind Prabahran, Mayani Rawicki, Lynette C. Y. Chee, Rachel M. Koldej & David S. Ritchie

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  1. Manu Juneja
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  2. Ashvind Prabahran
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  4. Lynette C. Y. Chee
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  5. Rachel M. Koldej
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  6. David S. Ritchie
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Contributions

RMK and DSR conceived and designed the project. MJ and MR collected the data. MJ and AP analysed the data. MJ and AP wrote the first version of the manuscript. All authors reviewed the data and contributed to critical revision of the manuscript.

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Correspondence to Manu Juneja.

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The authors declare no competing interests.

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Juneja, M., Prabahran, A., Rawicki, M. et al. The economic cost of care in poor graft function following allogeneic stem cell transplantation. Bone Marrow Transplant 60, 97–99 (2025). https://doi.org/10.1038/s41409-024-02452-7

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