Outpatient management of acute promyelocytic leukemia after consolidation chemotherapy

C. Girmenia, R. Latagliata, S. Tosti, S. G. Morano, F. Celesti, L. Coppola, A. Spadea, M. Breccia, R. Battistini, A. Tafuri, G. Cimino, F. Mandelli, G. Alimena

Research output: Contribution to journalArticle

18 Citations (Scopus)

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 languageEnglish
Pages (from-to)514-517
Number of pages4
JournalLeukemia
Volume13
Issue number4
Publication statusPublished - 1999

Fingerprint

Consolidation Chemotherapy
Acute Promyelocytic Leukemia
Outpatients
Hematologic Diseases
Hospital Emergency Service
Viridans Streptococci
Safety Management
Drug Therapy
Patient Readmission
Amikacin
Ceftriaxone
Intracranial Hemorrhages
Cross Infection
Neutropenia
Anemia
Fever
Therapeutics
Anti-Bacterial Agents
Costs and Cost Analysis
Incidence

Keywords

  • APL
  • Consolidation
  • Infections
  • Leukemia
  • Outpatient management

ASJC Scopus subject areas

  • Hematology
  • Cancer Research

Cite this

Girmenia, C., Latagliata, R., Tosti, S., Morano, S. G., Celesti, F., Coppola, L., ... Alimena, G. (1999). Outpatient management of acute promyelocytic leukemia after consolidation chemotherapy. Leukemia, 13(4), 514-517.

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 journalArticle

Girmenia, C, Latagliata, R, Tosti, S, Morano, SG, Celesti, F, Coppola, L, Spadea, A, Breccia, M, Battistini, R, Tafuri, A, Cimino, G, Mandelli, F & Alimena, G 1999, 'Outpatient management of acute promyelocytic leukemia after consolidation chemotherapy', Leukemia, vol. 13, no. 4, pp. 514-517.
Girmenia C, Latagliata R, Tosti S, Morano SG, Celesti F, Coppola L et al. Outpatient management of acute promyelocytic leukemia after consolidation chemotherapy. Leukemia. 1999;13(4):514-517.
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. / Outpatient management of acute promyelocytic leukemia after consolidation chemotherapy. In: Leukemia. 1999 ; Vol. 13, No. 4. pp. 514-517.
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