Outpatient consolidation chemotherapy in pediatric acute myeloid leukemia: a retrospective analysis

Abstract

Outpatient AML consolidation therapy is safe and feasible in children. It appears to result in less frequent invasive blood studies; shorter duration of febrile neutropenia and consequently less antimicrobial and antifungal usage as compared to inpatient consolidation cycles. To our knowledge, this report is the first of its kind looking specifically at outpatient consolidation chemotherapy in AML.

Ambulatory consolidation chemotherapy for acute myeloid leukemia with antibacterial prophylaxis is associated with frequent bacteremia and the emergence of fluoroquinolone resistant E. Coli

“…were the most common gram positive organisms. The rate of CNST isolates was not statistically different between C1 and C2, however, Streptococcus isolates, particularly S. viridans, increased from C1 to C2 within the younger cohort, likely reflecting the cumulative effects of HiDAC chemotherapy [11,28,30-32]. …”

Acute Myeloid Leukemia in Children: Experience from Tertiary Cancer Centre in India

“…It is also associated with significant financial burden for the family especially in resource poor settings [6]. There is paucity of published data from India on pediatric AML, treatment protocol and cytogenetics based risk stratification.…”

Feasibility of outpatient consolidation chemotherapy in older versus younger patients with acute myeloid leukemia

“…To our knowledge, this study represents the largest series of ambulatory AML consolidation patients reported to date and, unlike previous studies [1][2][3][4][5][6][7], includes a large proportion of patients over age 60. Overall, 50% of letters patients required readmission, mostly for treatment of febrile neutropenia with a mean duration of readmission of 2 weeks; therefore, even patients requiring readmission spent considerably less time as inpatients than would have been expected if they had been managed entirely on an inpatient basis.…”

“…Intensive consolidation chemotherapy for acute myeloid leukemia (AML) patients in complete remission is being increasingly administered on an outpatient basis. Although this approach has been found to be safe and feasible in younger patients [1][2][3][4][5][6], its safety in older patients remains unknown. We therefore undertook an evaluation of outpatient-based consolidation chemotherapy in older AML patients, and compared results to younger patients treated at the same institution over the same time period.…”

“…Table I. Reasons for planned inpatient (IP) treatment during the first consolidation cycle (C1) included anticoagulation monitoring (n 5 3), comorbidities or poor PS (14), continuing admission from induction (8), difficult induction (18), ongoing fungal infection (2), or other reasons (4). Reasons for planned IP admission for during the second consolidation cycle (C2) included comorbidities or poor PS (n 5 3), difficult C1 (12) and patient preference (7).…”