Abstract
The feasibility and safety of outpatient management of acute promyelocytic leukemia (APL) during the aplastic phase after intensive consolidation chemotherapy, the incidence and types of complications requiring readmission to hospital, and the number of hospital days spared by this policy have been prospectively evaluated. After chemotherapy administration, patients were evaluated on an ambulatory basis. In the event of any complication they referred to the Emergency Unit (EU) of our Department dedicated to outpatients with hematologic diseases. Forty patients with APL observed over a 4 year period were eligible for intensive chemotherapy. After the achievement of complete remission they received a total of 104 consolidation courses and in 98 instances they were followed on an ambulatory basis. There were 41 cases (42%) of rehospitalization for fever (40 cases) or severe anemia (one case). Only one patient died due to a brain hemorrhage. Streptococcus viridans was the organism most frequently isolated from blood. Empiric once-a-day antibacterial therapy with ceftriaxone and amikacin was effective in 87% of the cases and made possible early discharge in 28% of the cases to continue the antibiotic therapy on an outpatient setting. Patients were managed out of the hospital for 76% of the post-consolidation neutropenia period. Thanks to the availability of an EU specifically dedicated to outpatients with hematologic diseases, out-hospital management of APL patients after consolidation therapy appeared to be safe, well accepted, potentially cost-saving, and contributed to saving the risk of developing severe nosocomial infections.
| Original language | English |
|---|---|
| Pages (from-to) | 514-517 |
| Number of pages | 4 |
| Journal | Leukemia |
| Volume | 13 |
| Issue number | 4 |
| Publication status | Published - 1999 |
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Keywords
- APL
- Consolidation
- Infections
- Leukemia
- Outpatient management
ASJC Scopus subject areas
- Hematology
- Cancer Research
Cite this
Outpatient management of acute promyelocytic leukemia after consolidation chemotherapy. / Girmenia, C.; Latagliata, R.; Tosti, S.; Morano, S. G.; Celesti, F.; Coppola, L.; Spadea, A.; Breccia, M.; Battistini, R.; Tafuri, A.; Cimino, G.; Mandelli, F.; Alimena, G.
In: Leukemia, Vol. 13, No. 4, 1999, p. 514-517.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Outpatient management of acute promyelocytic leukemia after consolidation chemotherapy
AU - Girmenia, C.
AU - Latagliata, R.
AU - Tosti, S.
AU - Morano, S. G.
AU - Celesti, F.
AU - Coppola, L.
AU - Spadea, A.
AU - Breccia, M.
AU - Battistini, R.
AU - Tafuri, A.
AU - Cimino, G.
AU - Mandelli, F.
AU - Alimena, G.
PY - 1999
Y1 - 1999
N2 - The feasibility and safety of outpatient management of acute promyelocytic leukemia (APL) during the aplastic phase after intensive consolidation chemotherapy, the incidence and types of complications requiring readmission to hospital, and the number of hospital days spared by this policy have been prospectively evaluated. After chemotherapy administration, patients were evaluated on an ambulatory basis. In the event of any complication they referred to the Emergency Unit (EU) of our Department dedicated to outpatients with hematologic diseases. Forty patients with APL observed over a 4 year period were eligible for intensive chemotherapy. After the achievement of complete remission they received a total of 104 consolidation courses and in 98 instances they were followed on an ambulatory basis. There were 41 cases (42%) of rehospitalization for fever (40 cases) or severe anemia (one case). Only one patient died due to a brain hemorrhage. Streptococcus viridans was the organism most frequently isolated from blood. Empiric once-a-day antibacterial therapy with ceftriaxone and amikacin was effective in 87% of the cases and made possible early discharge in 28% of the cases to continue the antibiotic therapy on an outpatient setting. Patients were managed out of the hospital for 76% of the post-consolidation neutropenia period. Thanks to the availability of an EU specifically dedicated to outpatients with hematologic diseases, out-hospital management of APL patients after consolidation therapy appeared to be safe, well accepted, potentially cost-saving, and contributed to saving the risk of developing severe nosocomial infections.
AB - The feasibility and safety of outpatient management of acute promyelocytic leukemia (APL) during the aplastic phase after intensive consolidation chemotherapy, the incidence and types of complications requiring readmission to hospital, and the number of hospital days spared by this policy have been prospectively evaluated. After chemotherapy administration, patients were evaluated on an ambulatory basis. In the event of any complication they referred to the Emergency Unit (EU) of our Department dedicated to outpatients with hematologic diseases. Forty patients with APL observed over a 4 year period were eligible for intensive chemotherapy. After the achievement of complete remission they received a total of 104 consolidation courses and in 98 instances they were followed on an ambulatory basis. There were 41 cases (42%) of rehospitalization for fever (40 cases) or severe anemia (one case). Only one patient died due to a brain hemorrhage. Streptococcus viridans was the organism most frequently isolated from blood. Empiric once-a-day antibacterial therapy with ceftriaxone and amikacin was effective in 87% of the cases and made possible early discharge in 28% of the cases to continue the antibiotic therapy on an outpatient setting. Patients were managed out of the hospital for 76% of the post-consolidation neutropenia period. Thanks to the availability of an EU specifically dedicated to outpatients with hematologic diseases, out-hospital management of APL patients after consolidation therapy appeared to be safe, well accepted, potentially cost-saving, and contributed to saving the risk of developing severe nosocomial infections.
KW - APL
KW - Consolidation
KW - Infections
KW - Leukemia
KW - Outpatient management
UR - http://www.scopus.com/inward/record.url?scp=0032957089&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0032957089&partnerID=8YFLogxK
M3 - Article
C2 - 10214855
AN - SCOPUS:0032957089
VL - 13
SP - 514
EP - 517
JO - Leukemia
JF - Leukemia
SN - 0887-6924
IS - 4
ER -