Contributions
Abstract: PB1736
Type: Publication Only
Background
Effective treatment of acute myeloid leukemia (AML) includes the induction remission therapy which is followed by consolidation chemotherapy. Regimens for consolidation are as intensive as induction therapy, and in the most centers are usually given in an inpatient basis, for 2-3 cycles, lasting approximately for a total of 3–4 months. Given the practical considerations such as healthcare costs and limited inpatient resources and the current advantages in the supportive care post chemotherapy, the administration of consolidation treatment in an outpatient basis emerges as an appealing approach.
Aims
In this study we evaluated the feasibility and safety of high dose Cytarabine (HiDAC) as consolidation treatment in an outpatients basis
Methods
Sixteen patients of a median age 48,5 (17-64) years who met the eligibility criteria (good compliance, general health status WHO: 0-1, no severe preceding or residual infections, timely reach the hospital services) received in a total 20 cycles of HiDAC (2g/m2 intravenously over 3 hours infusion, twice daily for 3 days); 4 patient received 2 cycles of HiDAC. All patients received orally prophylaxis against bacterial, viral and fungal infection started from the 1st day of chemotherapy infusion till blood-counts recovery. GCSF was not given routinely for neutrophils recovery. Chemotherapy and supportive care were given in an allocated room in our department. Patients and their relatives had been previously informed in details regarding the consequences and the potential risks of chemotherapy. Patients were closely monitored (every 1-2 days) in the outpatient clinic
Results
All the 20 cycles successfully completed and no severe side effects occurred during chemotherapy infusion; patients mainly complained for nausea and mild vomiting which fully controlled with the appropriate treatment. The median day for neutrophils (>500/mm3) and platelets (>20000/mm3) recovery were +21 (19-24) and +23 (19-26) after HiDAC treatment. Only 3 /16 patients were admitted for a total of 13 days (5, 5 and 3 days respectively), for neutropenic fever of unknown origin. All cases promptly responded to the treatment and no patient admitted to intensive care unit.
Conclusion
Our study demonstrated that HiDAC can be safely given in an outpatient basis, provided that the aforementioned eligibility criteria are met. The extremely short hospitalization period (13 days for the total of 20 HiDAC cycles) resulted in lower exposure to nosocomial pathogens, saving also significant inpatients beds. Keeping also in mind that the inpatient administration of HiDAc usually requires at least 20 hospitalization-days per cycle, we can easily conclude that the outpatient approach of HiDAC chemotherapy offers also significant cost effectiveness.
Session topic: 4. Acute myeloid leukemia - Clinical
Keyword(s): Acute Myeloid Leukemia, chemotherapy
Abstract: PB1736
Type: Publication Only
Background
Effective treatment of acute myeloid leukemia (AML) includes the induction remission therapy which is followed by consolidation chemotherapy. Regimens for consolidation are as intensive as induction therapy, and in the most centers are usually given in an inpatient basis, for 2-3 cycles, lasting approximately for a total of 3–4 months. Given the practical considerations such as healthcare costs and limited inpatient resources and the current advantages in the supportive care post chemotherapy, the administration of consolidation treatment in an outpatient basis emerges as an appealing approach.
Aims
In this study we evaluated the feasibility and safety of high dose Cytarabine (HiDAC) as consolidation treatment in an outpatients basis
Methods
Sixteen patients of a median age 48,5 (17-64) years who met the eligibility criteria (good compliance, general health status WHO: 0-1, no severe preceding or residual infections, timely reach the hospital services) received in a total 20 cycles of HiDAC (2g/m2 intravenously over 3 hours infusion, twice daily for 3 days); 4 patient received 2 cycles of HiDAC. All patients received orally prophylaxis against bacterial, viral and fungal infection started from the 1st day of chemotherapy infusion till blood-counts recovery. GCSF was not given routinely for neutrophils recovery. Chemotherapy and supportive care were given in an allocated room in our department. Patients and their relatives had been previously informed in details regarding the consequences and the potential risks of chemotherapy. Patients were closely monitored (every 1-2 days) in the outpatient clinic
Results
All the 20 cycles successfully completed and no severe side effects occurred during chemotherapy infusion; patients mainly complained for nausea and mild vomiting which fully controlled with the appropriate treatment. The median day for neutrophils (>500/mm3) and platelets (>20000/mm3) recovery were +21 (19-24) and +23 (19-26) after HiDAC treatment. Only 3 /16 patients were admitted for a total of 13 days (5, 5 and 3 days respectively), for neutropenic fever of unknown origin. All cases promptly responded to the treatment and no patient admitted to intensive care unit.
Conclusion
Our study demonstrated that HiDAC can be safely given in an outpatient basis, provided that the aforementioned eligibility criteria are met. The extremely short hospitalization period (13 days for the total of 20 HiDAC cycles) resulted in lower exposure to nosocomial pathogens, saving also significant inpatients beds. Keeping also in mind that the inpatient administration of HiDAc usually requires at least 20 hospitalization-days per cycle, we can easily conclude that the outpatient approach of HiDAC chemotherapy offers also significant cost effectiveness.
Session topic: 4. Acute myeloid leukemia - Clinical
Keyword(s): Acute Myeloid Leukemia, chemotherapy