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Walter RB, Taylor LR, Gardner KM, et al. Outpatient management following intensive induction or salvage chemotherapy for acute myeloid leukemia. Clin Adv Hematol Oncol. 2013;11(9):571-7
Walter, R. B., Taylor, L. R., Gardner, K. M., Dorcy, K. S., Vaughn, J. E., & Estey, E. H. (2013). Outpatient management following intensive induction or salvage chemotherapy for acute myeloid leukemia. Clinical advances in hematology & oncology : H&O, 11(9), 571-7.
Walter, Roland B, et al. "Outpatient management following intensive induction or salvage chemotherapy for acute myeloid leukemia." Clinical advances in hematology & oncology : H&O vol. 11,9 (2013): 571-7.
Walter RB, Taylor LR, Gardner KM, Dorcy KS, Vaughn JE, Estey EH. Outpatient management following intensive induction or salvage chemotherapy for acute myeloid leukemia. Clin Adv Hematol Oncol. 2013;11(9):571-7. PMID: 24518520; PMCID: PMC4212516.
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Clin Adv Hematol Oncol. 2013;11(9):571-7.

Outpatient management following intensive induction or salvage chemotherapy for acute myeloid leukemia.

Clinical advances in hematology & oncology : H&O

Roland B Walter, Lenise R Taylor, Kelda M Gardner, Kathleen Shannon Dorcy, Jennifer E Vaughn, Elihu H Estey

Affiliations

  1. Assistant member in the clinical research division at the Fred Hutchinson Cancer Research Center, and an assistant professor in the department of medicine at the University of Washington School of Medicine in Seattle, Washington.
  2. Clinical nurse specialist for the Seattle Cancer Care Alliance and the University of Washington Medical Center in Seattle, Washington.
  3. Physician assistant at the Seattle Cancer Care Alliance and teaching associate at the University of Washington Medical Center in Seattle, Washington.
  4. Director of research development at the Seattle Cancer Care Alliance and a staff scientist at the Fred Hutchinson Cancer Research Center in Seattle, Washington.
  5. Senior research fellow at the Fred Hutchinson Cancer Research Center in Seattle, Washington.
  6. Member of the clinical research division at the Fred Hutchinson Cancer Research Center, and a professor in the department of medicine at the University of Washington School of Medicine in Seattle, Washington.

PMID: 24518520 PMCID: PMC4212516

Abstract

Adults with newly diagnosed or relapsed acute myeloid leukemia (AML) commonly receive intensive chemotherapy to achieve disease remission. In the United States and many other countries, it is standard practice that these patients remain hospitalized "preemptively" until blood count recovery, owing to the risk for overwhelming infections and bleeding during pancytopenia. This care policy requires hospitalization for an average of 3 to 4 weeks after completion of chemotherapy. However, highly effective oral prophylactic antimicrobials are now available, and transfusion support of outpatients has become routine in recent years. As a result, the care of patients with hematologic malignancies treated with intensive modalities is increasingly shifting from inpatient to outpatient settings. Benefits of this shift could include the reduced need for medical resources (eg, transfusions or intravenous antimicrobial therapy), improved quality of life (QOL), decreased rates of nosocomial infections, and lower costs. Increasing evidence indicates that select AML patients undergoing intensive remission induction or salvage chemotherapy can be discharged early after completion of chemotherapy and followed closely in a well-equipped outpatient facility in a safe and costeffective manner. Further demonstration that the current approach of preemptive hospitalization is medically unjustified, economically more burdensome, and adversely affects health-related QOL would very likely change the management of these patients throughout this country and elsewhere, resulting in the establishment of a new standard practice that improves cancer care.

References

  1. Eur J Cancer. 2008 Jul;44(11):1497-506 - PubMed
  2. Haematologica. 2011 Jun;96(6):914-7 - PubMed
  3. Int J Clin Pharm. 2011 Apr;33(2):191-9 - PubMed
  4. Semin Hematol. 2001 Oct;38(4 Suppl 10):32-7 - PubMed
  5. Drugs. 2012 Mar 26;72(5):685-704 - PubMed
  6. Ann Oncol. 2006 May;17(5):763-8 - PubMed
  7. Cancer. 2006 Mar 1;106(5):1090-8 - PubMed
  8. Onkologie. 2010;33(12):658-64 - PubMed
  9. Blood. 2007 Mar 1;109(5):1810-6 - PubMed
  10. N Engl J Med. 2005 Sep 8;353(10):977-87 - PubMed
  11. J Clin Oncol. 2011 Nov 20;29(33):4417-23 - PubMed
  12. Int J Technol Assess Health Care. 1994 Fall;10(4):683-94 - PubMed
  13. N Engl J Med. 1999 Sep 30;341(14):1051-62 - PubMed
  14. Ann Intern Med. 1966 Feb;64(2):328-40 - PubMed
  15. Int J Technol Assess Health Care. 2007 Winter;23(1):43-53 - PubMed
  16. J Clin Oncol. 2007 May 10;25(14):1908-15 - PubMed
  17. Cancer Treat Rev. 2004 May;30(3):237-47 - PubMed
  18. Leuk Res. 2013 Mar;37(3):245-50 - PubMed
  19. Blood. 2010 Jan 21;115(3):453-74 - PubMed
  20. J Clin Oncol. 2011 Feb 10;29(5):487-94 - PubMed
  21. Ann Oncol. 2007 Jul;18(7):1246-52 - PubMed
  22. Cancer. 2004 Jan 15;100(2):228-37 - PubMed
  23. Blood. 1983 Jul;62(1):1-13 - PubMed
  24. Bull Cancer. 2006 Aug;93(8):813-9 - PubMed
  25. Leuk Res. 1994 Oct;18(10):783-90 - PubMed
  26. Blood. 2006 May 1;107(9):3481-5 - PubMed
  27. J Natl Compr Canc Netw. 2008 Feb;6(2):109-18 - PubMed
  28. Presse Med. 1992 Sep 12;21(29):1364-8 - PubMed
  29. Am J Hematol. 1996 Jan;51(1):26-31 - PubMed
  30. Lancet. 2006 Nov 25;368(9550):1894-907 - PubMed
  31. Br J Haematol. 2007 Feb;136(4):624-7 - PubMed
  32. Haematologica. 1999 Sep;84(9):814-9 - PubMed
  33. Lancet. 2010 Dec 11;376(9757):2000-8 - PubMed
  34. Eur J Haematol. 1995 Jan;54(1):18-20 - PubMed
  35. Lancet. 2013 Feb 9;381(9865):484-95 - PubMed
  36. Onkologie. 2001 Jun;24(3):292-4 - PubMed
  37. Leuk Lymphoma. 2001 Jul;42(3):339-46 - PubMed
  38. Eur J Haematol. 2010 Apr;84(4):316-22 - PubMed
  39. N Engl J Med. 2007 Oct 18;357(16):1573-5 - PubMed
  40. Arch Intern Med. 2002 Jul 22;162(14):1597-603 - PubMed
  41. Am J Hematol. 2012 Jul;87(7):692-701 - PubMed
  42. Am J Hematol. 2006 Nov;81(11):850-7 - PubMed
  43. Bratisl Lek Listy. 2012;113(5):298-300 - PubMed
  44. CA Cancer J Clin. 2013 Jan;63(1):11-30 - PubMed

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