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Postinduction Supportive Care of Pediatric Acute Myelocytic Leukemia: Should Patients be Kept in the Hospital?

Susumu Inoue1, Isra'a Khan2, Rao Mushtaq2

  • 1Hurley Children's Hospital and Hurley Medical Center, One Hurley Plaza, Flint, MI 48503, USA ; Department of Pediatrics/Human Development, Michigan State University College of Human Medicine, One Hurley Plaza, Flint, MI 48503, USA.

Leukemia Research and Treatment
|October 29, 2014
PubMed

Insights

Discharging children with acute myeloid leukemia (AML) while neutropenic after chemotherapy did not increase neutropenia-related deaths. This small study suggests hospital discharge is safe for these pediatric cancer patients.

Area of Science:

  • Pediatric Oncology
  • Hematology

Background:

  • Children with acute myeloid leukemia (AML) experience profound neutropenia during remission induction chemotherapy.
  • The safety of hospital discharge during severe neutropenia in pediatric AML patients is not well-established.

Purpose of the Study:

  • To evaluate whether discharging pediatric AML patients during profound neutropenia impacts survival.

Main Methods:

  • Retrospective review of AML patients treated at the institution from 1989 to 2011.
  • Analysis of outcomes for 13 patients electively discharged during severe neutropenia post-induction chemotherapy.

Main Results:

  • Four patients died due to relapse or transplant complications, not neutropenia-related issues.
  • Eight patients achieved long-term survival.
  • Elective discharge during profound neutropenia did not appear to negatively affect survival in this cohort.

Conclusions:

  • Hospital discharge of pediatric AML patients with profound neutropenia, when clinically appropriate, may be a safe practice.
  • Further research with larger cohorts is warranted to confirm these findings.

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