Objectives: To compare outcome attributes of three availabletechnologies for stem cell transplantation—bone marrowtransplantation (BM), peripheral blood cell transplantation (PB), andcord blood transplantation (CB). To compare the cost per recipient forthe three technologies, incorporating all donor and antigen matching functions, as well as the transplantation procedures.

Methods: Review of relevant literature using the CancerLit andHealthSTAR databases (plus earlier searches of MEDLINE and Embase) tosummarize outcome differences. Estimations of cost per transplantusing models drawing on Canadian experience.

Results: The literature review indicated that PB may have amodest advantage over BM in terms of outcomes. The literatureindicated that CB has longer engraftment times (although this may bedue to inadequate controls). Our modeling exercise indicated that costs for PB and BM are similar. CB has a higher cost per recipient,due in large part to the higher testing costs for every donated unit.

Conclusions: Current literature is inadequate to provide anoutcomes comparison of CB, PB, and BM. Viewed from a system-wideperspective, CB is a higher cost technique. However, PB and CB areemerging as technologies, and so our results should be viewedalongside the notion that there may be a steep learning curve in these technologies.