Outpatient supportive therapy after induction to remission therapy in adult acute myelogenous leukaemia (AML) is feasible: a multicentre study

Abstract

Abstract: Twenty‐four adult patients with AML were treated with standard “7 + 3”chemotherapy. After administering the myeloablative drugs in the hospital, patients were instructed to continue their supportive treatment on an outpatient basis; they received ciprofloxacin, cotrimoxasole and itraconazole vo until the absolute granulocyte count rose above 1 × 10 9 /l. Platelet concentrates were given every other day until the platelet count rose above 20 × 10 9 /l. Complete remission (CR) was obtained in 87%. Fever developed in 29% and 2 cases were complicated by indwelling‐catheter‐related Pseudomona aeruginosa septicaemia, 1 Entamoeba hystolytica enteritis and 1 Pneumocystis carinii pneumonia; these patients were hospitalized to treat these infections specifically. In no case was the infection fatal. The median disease free‐survival (DFS) was 17 months, 12‐month DFS was 66%, and 30‐month DFS was 17%. Our calculations have shown that 1700 USD/patient were saved by avoiding prolonged hospitalization; this may provide not only economical, but also psychological advantages to patients.