Complications and hospital costs during hematopoietic stem cell transplantation for non-Hodgkin lymphoma in the United States

Abstract

While the initial hospitalization accounts for 75% of total healthcare costs during the first 100 days following hematopoietic stem cell transplantation (HSCT), there is a lack of studies evaluating the considerable variation in cost estimates. Using the National Inpatient Sample (NIS) database from 2012–2014, we identified 1832 adult non-Hodgkin lymphoma (NHL) patients who received autologous or allogeneic HSCT and examined complications as predictors of hospital cost. Complications occurred in >70% of patients, and the presence of one or more complications was associated with an increase in mean hospital costs of 46% in autologous HSCT and 81% in allogeneic HSCT. The most common complications (∼40%) were mucositis, febrile neutropenia, and infection. Acute organ failure, acute graft-versus-host disease, and death were less frequent (∼10%) but had a greater impact on increasing hospital costs and length of stays. Despite recent advances in supportive care and pre-conditioning regimens, complications are common and costly during HSCT.