We analyzed the cost effectiveness of leukocyte transfusion in preventing death from infection during intensive chemotherapy for acute leukemia. Effectiveness was estimated with an odds-ratio analysis based on published results of controlled studies of therapeutic and prophylactic leukocyte transfusion. Cost estimates were based on blood-bank charges throughout the country. Calculations of effectiveness suggest that leukocyte transfusion might prevent 50 to 75% of early deaths from infection. Therapeutic transfusion would add approximately 10.9% to the hospital bill of the average bill of the average leukemic patient and cost $17.7 million annually nationwide. Prophylactic transfusion would add 35.2% to the hospital bill and cost $57.8 million annually. Mean cost-effectiveness ratios were $14,982 per life-year for therapeutic transfusion and $35,020 to $50,029 per life-year for prophylactic transfusion. The cost per additional life-year achieved with prophylactic rather than therapeutic leukocyte transfusion was $85,291. These data suggest that leukocyte transfusion is an extremely expensive technologic procedure.
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