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


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.

SUBMITTER: Miller TP 

PROVIDER: S-EPMC4899280 | biostudies-literature | 2016 Jul

REPOSITORIES: biostudies-literature

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

Miller Tamara P TP   Getz Kelly D KD   Kavcic Marko M   Li Yimei Y   Huang Yuan-Shun V YS   Sung Lillian L   Alonzo Todd A TA   Gerbing Robert R   Daves Marla M   Horton Terzah M TM   Pulsipher Michael A MA   Pollard Jessica J   Bagatell Rochelle R   Seif Alix E AE   Fisher Brian T BT   Gamis Alan S AS   Aplenc Richard R  

Leukemia & lymphoma 20160104 7


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  ...[more]

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