Thanks to the availability of an emergency unit specifically dedicated to out-patients with hematologic diseases, selected out-hospital management of AML patients during post-consolidation cytopenia is a feasible, well accepted and cost-saving option, and can contribute to lower the risk of developing severe nosocomial infections. The empiric therapy with once-a-day ceftriaxone plus amikacin was effective, with the exception of staphylococcal infections, and made it possible to discharge patients early to continue treatment in an out-patient setting.
RATIONALE: Gathering information about patients with myelodysplastic syndrome or acute myeloid leukemia who are discharged after finishing chemotherapy, or who stay in the hospital until blood counts return to normal, may help doctors learn more about a patient's quality of life, use of medical services, and the cost of these services.
PURPOSE: This clinical trial is studying early discharge and outpatient care in patients who have undergone chemotherapy for myelodysplastic syndrome or acute myeloid leukemia.
*Within 72 hours after completion of induction chemotherapy, patients are discharged from the hospital.
In recent years, several reports have questioned the necessity of keeping patients in hospital after chemotherapy till full neutrophil count recovery. This study shows that selected patients can be discharged and given domiciliary treatment safely, even with inadequate home care facilities.
These data are important as there has been lingering concern that Neupogen could increase the relapse rate by stimulating myeloid blasts. However, this study clearly demonstrates that Neupogen, and by extrapolation the more commonly used Neulasta® (pegfilgrastim), can be used safely in patients with AML.
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