Background: This study assessed the feasibility and safety of outofhospital management of acute myeloid leukemia (AML) patients during consolidation therapy. Methods: 103 consolidation cycles were analyzed retrospectively. All patients received treatment as inpatients; they were discharged provided they were in a good clinical condition and then either electively readmitted or managed as outpatients during the aplastic phase. Results: In 95/103 cycles (92%), discharge was feasible after a median of 7 (6–16) days. In 45 cycles, patients were electively readmitted at the onset of chemotherapyinduced cytopenia after a median time of 12 (9–16) days. In 50 cycles, patients were managed as outpatients. In 23/50 outpatient cycles (46%), patients required rehospitalization, the main cause being neutropenic fever. There was 1 treatmentrelated death due to sepsis in a patient in the outpatient group, accounting for an overall mortality of 2%. Transfusion requirements, occurrence of grade 3–4 toxicity, and diseasefree and overall survival after a median followup of 20 months did not differ between the treatment strategies. Comparison of diagnosisrelated group (DRG) proceeds revealed a 40% reduction with the outpatient strategy. Conclusion: Outpatient management of consolidation therapy in selected AML patients appears to be feasible and safe and may reduce hospital treatment costs.

Keywords:
Acute myeloid leukemia, Outpatient treatment, Febrile neutropenia, Treatment costs
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© 2010 S. Karger AG, Basel
2010
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