Bone Marrow Transplantation:

International Comparisons of Availability and Appropriateness of Use

PEMD-94-10: Published: Mar 7, 1994. Publicly Released: Mar 7, 1994.

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Pursuant to a congressional request, GAO reviewed the variation among the United States and nine other medically advanced countries in the allocation of allogeneic bone marrow transplantation, focusing on availability and appropriateness.

GAO found that: (1) for the years 1989-91, the United States was near the middle of the 10 countries regarding the availability of transplantation and the appropriateness of its use; (2) U.S. patients with chronic myeloid leukemia were less likely to receive a transplant than patients in six other countries; (3) U.S. patients with acute myeloid leukemia were more likely to receive a transplant than patients in seven other countries; (4) the time from diagnosis to transplantation for U.S. patients with acute leukemia was relatively short; (5) the United States had relatively more patients receiving transplants at less favorable stages of their diseases than in most other countries; (6) in the case of chronic myeloid leukemia, five other countries were ahead of the United States in providing transplants in the early, most favorable stage; and (7) relative to other countries, some U.S. patients for whom the treatment offered few likely benefits received transplants, while others who could benefit more did not.

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