A new pilot study demonstrated that an outpatient induction chemotherapy program for patients with acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS) showed feasibility. The results were published in the journal Blood Advances.
Patients with AML or high-risk MDS were eligible to participate in this feasibility study of outpatient care if they had expected death rates of less than 5% to 10% within 28 days of treatment and also did not have active infections or significant organ damage.
The median patient age was 53 years; 88% of patients had AML and 12% had MDS with excess blasts, type 2.
In this study 17 patients were given outpatient induction chemotherapy, as initial treatment for 8 of them and as salvage therapy for 9 patients. A total of 14 patients (82.4%) completed treatment on an outpatient basis, while 3 were admitted for inpatient care attributed to neutropenic fever (2 patients) and grade 3 mucositis (1 patient).
No fatalities were reported in the first 14 days following the start of induction. In the first 60 days after the start of induction, 2 patients who had received outpatient induction died.
The most common chemotherapy regimen with outpatient induction was the combination of cladribine, cytarabine, and mitoxantrone with granulocyte colony-stimulating factor, given to 41% of patients.
Outpatient induction chemotherapy is safe for patients with AML or high-risk MDS and will not incur excessive use of blood products or other resources, the investigators noted. A multidisciplinary team of nurses, social workers, medical providers, and pharmacists provided substantial support in enabling this outpatient program.
Mabrey FL, Gardner KM, Dorcy KS, et al. Outpatient intensive induction chemotherapy for acute myeloid leukemia and high-risk myelodysplastic syndrome. Blood Adv. 2020;4(4):611-616.