Summary:Allogeneic hematopoietic stem cell transplantation (SCT) is a widely used, cost-intensive procedure. Although pretransplant nonmyeloablative (NMA) or reduced-intensity conditioning regimens appear very promising, prospective studies comparing this approach with the conventional myeloablative (MA) approach in specific hematologic diseases are necessary, especially in patients in whom the conventional approach is not contraindicated. Cost may be an important factor in the decision-making process. We compared the costs of MA and NMA transplants in patients with acute myeloid leukemia (AML). We estimated 1-year resource utilization in 12 consecutive MA patients (median age: 39 years) and in 11 consecutive NMA patients (median age: 58 years) who underwent HLA-identical sibling SCT for AML. Resources care expenses were valued using the average daily rate for personnel costs, supplies, and room costs. Other data were directly collected from the patients' charts. Despite a trend for lower costs in NMA patients during the first 6 months, costs during the 6-12-month period were significantly higher after NMA due to late complications and readmissions (P ¼ 0.03). Finally, mean 1-year costs were not different in MA and NMA patients (P ¼ 0.75). Prospective studies comparing conventional and NMA approaches in homogeneous populations should include economic items. Bone Marrow Transplantation (2005) 36, 649-654. doi:10.1038/sj.bmt.1705109; published online 25 July 2005 Keywords: allogeneic hematopoietic stem cell transplantation; costs; reduced-intensity conditioning regimen Nonmyeloablative (NMA) or reduced intensity conditioning regimens for allogeneic stem cell transplants (SCT) were mainly developed for older patients and those with contraindications to conventional myeloablative (MA) regimens in various hematologic diseases including myeloid 1-9 and lymphoid 10,11 malignancies. In these studies, patients were mostly older than the typical allogeneic SCT recipients and those in the historical control group. [9][10][11][12] Despite this limitation, and the fact that no prospective comparisons between the NMA and MA approaches have been published to date, these studies have shown that NMA transplant may result in an acceptable outcome in patients with no other alternative. One common finding in these series is that the NMA approach reduces the duration of the initial neutropenic phase, 1,2 reduces blood transfusion requirements, 4,5,8 decreases transplant-related mortality, 9,13 and may even be used in an outpatient setting.14 Given these findings, the overall cost of the NMA procedure including drugs, blood products, and hospital resource utilization would be expected to be lower than the conventional treatment using MA conditioning, which usually requires at least 4 weeks of hospitalization compared to 0-3 weeks with the NMA approach. Considering the low transplant-related mortality of the procedure in several series, 4,5,8 the time has come to conduct prospective comparative studies between NMA and MA approaches in...

L (liver) type phosphofructokinase subunits purified from human leukocytes are slightly lighter than L subunits from liver and red blood cells. A mild treatment of red blood cell L4 enzyme with subtilisin converts its subunits into forms of similar molecular weight to leukocyte enzyme. From a kinetical point of view, subtilisin-treated L(4) phosphofructokinase and leukocyte enzymes are characterized by a decrease of the allosteric properties as compared to non-treated red cell L(4) phosphofructokinase.