At home treatment after high-dose chemotherapy and autologous stem cell transplantation is safe and feasible. Evaluation of 4 years of ambulatory care from a medical, nursing, patient and 64257; nancial perspective

Ref ID: 18551

Author:

A. Mank, C. Schoonenberg, K. Bleeker, S. Heijmenberg,
K. de Heer, R. de Haan, R. van Oers, M.J. Kersten

Author address:

Academic Medical Centre (Amsterdam, NL)

Full conference title:

Annual Meeting of the EBMT, 38th

Abstract:

The necessity of keeping patients in hospital during neutropenia after high dose chemotherapy is under discussion. A prospective, nonrandomized clinical study was done to examine
the safety of ambulatory care in patients undergoing consolidation chemotherapy for acute leukemia, or autologous stem
cell transplantation for lymphoma or multiple myeloma. Patients
fulfi lling the eligibility criteria were discharged into ambulatory
care the day after the last chemotherapy administration, or
the day after reinfusion of the stem cells. Patients visited the
ambulatory care unit 3 times a week for monitoring of signs,
symptoms and laboratory results.
During the study period, 165 patients were admitted for 208
chemotherapy cycles. 76 patients in 89 cycles could not be
included in the ambulatory care program, most frequently either
because their medical situation did not allow for early discharge
(58%), or because they had no care giver (14.6%), or had to
travel a large distance to the hospital (14.6%).
The 89 patients in the ambulatory care group, who underwent
119 cycles of high dose chemotherapy, spent almost 70% of the
neutropenic phase at home. 37 out of 89 patients (46 cycles)
were never readmitted to the hospital. None of these patients
had to be admitted to the intensive care, and there was no treatment related mortality In the hospital group, 2 patients died, one
because of pneumonia and one because of invasive aspergillosis.
Patients and their caregivers felt safe and comfortable at home,
and the vast majority preferred home care over in-hospital
treatment.
This study demonstrates the safety and feasibility of managing
carefully selected patients in an ambulatory care setting after
high dose chemotherapy.

Abstract Number: P479

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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