A comparison of discharge strategies after chemotherapy completion in pediatric patients with acute myeloid leukemia: a report from the Children's Oncology Group.

TitleA comparison of discharge strategies after chemotherapy completion in pediatric patients with acute myeloid leukemia: a report from the Children's Oncology Group.
Publication TypeJournal Article
Year of Publication2016
AuthorsMiller TP, Getz KD, Kavcic M, Li Y, Huang Y-SV, Sung L, Alonzo TA, Gerbing R, Daves M, Horton TM, Pulsipher MA, Pollard JA, Bagatell R, Seif AE, Fisher BT, Gamis AS, Aplenc R
JournalLeuk Lymphoma
Pagination1-8
Date Published2016 Jan 4
ISSN1029-2403
Abstract

While most children receive acute myeloid leukemia (AML) chemotherapy as inpatients, there is variability in timing of discharge after chemotherapy completion. This study compared treatment-related morbidity, mortality and cumulative hospitalization in children with AML who were discharged after chemotherapy completion (early discharge) and those who remained hospitalized. Chart abstraction data for 153 early discharge-eligible patients enrolled on a Children's Oncology Group trial were compared by discharge strategy. Targeted toxicities included viridans group streptococcal (VGS) bacteremia, hypoxia and hypotension. Early discharge occurred in 11% of courses post-Induction I. Re-admission occurred in 80-100%, but median hospital stay was 7 days shorter. Patients discharged early had higher rates of VGS (adjusted risk ratio (aRR) = 1.67, 95% CI = 1.11-2.51), hypoxia (aRR = 1.92, 95% CI = 1.06-3.48) and hypotension (aRR = 4.36, 95% CI = 2.01-9.46), but there was no difference in mortality. As pressure increases to shorten hospitalizations, these results have important implications for determining discharge practices in pediatric AML.

DOI10.3109/10428194.2015.1088652
Alternate JournalLeuk. Lymphoma
PubMed ID26727639