Comparable Inpatient Costs and Resource Utilization with TCRαβ+/CD19+-Depleted Compared with Conventional Stem Cell Transplant for Pediatric Hematologic Malignancies.

T-cell receptor alpha/beta+ T-cell/CD19+ B-cell (TCRαβ+/CD19+) depletion of allografts is increasingly used as a graft manipulation strategy for allogeneic hematopoietic stem cell transplantation (HSCT) for hematologic malignancies. While outcomes using this approach are encouraging, limited data exist on associated costs and healthcare resource utilization (HRU). We conducted a single-center analysis comparing costs and HRU through HSCT day +100 in patients who received a TCRαβ+/CD19+-depleted (TCD) HSCT (n = 20) to a contemporary cohort of patients who received a non-TCD HSCT (n = 22). Median total inpatient costs through day +100 were $623,085 (interquartile range (IQR): $356,466-1,081,013] for TCD HSCTs and $451,876 (IQR: $313,601-787,351) for non-TCD HSCTs (P = 0.234). Engraftment was rapid, with a median time to neutrophil engraftment of 10.0 versus 21.0 days (P < 0.001) and platelet engraftment of 11.0 versus 22.0 days (P < 0.001) for TCD and non-TCD HSCTs, respectively. Length of stay for the initial admission was shorter for patients who received a TCD HSCT (28.5 vs. 34.0 days, P < 0.001). Readmission through day +100 was required for 12 (60.0%) TCD patients and 6 (27.3%) non-TCD (P = 0.060). In summary, while clinical outcomes were comparable, costs and HRU were not decreased after TCRαβ+/CD19+ depletion.