PMID- 10214855
OWN - NLM
STAT- MEDLINE
DCOM- 19990510
LR  - 20190915
IS  - 0887-6924 (Print)
IS  - 0887-6924 (Linking)
VI  - 13
IP  - 4
DP  - 1999 Apr
TI  - Outpatient management of acute promyelocytic leukemia after consolidation 
      chemotherapy.
PG  - 514-7
AB  - The feasibility and safety of outpatient management of acute promyelocytic 
      leukemia (APL) during the aplastic phase after intensive consolidation 
      chemotherapy, the incidence and types of complications requiring readmission to 
      hospital, and the number of hospital days spared by this policy have been 
      prospectively evaluated. After chemotherapy administration, patients were 
      evaluated on an ambulatory basis. In the event of any complication they referred 
      to the Emergency Unit (EU) of our Department dedicated to outpatients with 
      hematologic diseases. Forty patients with APL observed over a 4 year period were 
      eligible for intensive chemotherapy. After the achievement of complete remission 
      they received a total of 104 consolidation courses and in 98 instances they were 
      followed on an ambulatory basis. There were 41 cases (42%) of rehospitalization 
      for fever (40 cases) or severe anemia (one case). Only one patient died due to a 
      brain hemorrhage. Streptococcus viridans was the organism most frequently 
      isolated from blood. Empiric once-a-day antibacterial therapy with ceftriaxone 
      and amikacin was effective in 87% of the cases and made possible early discharge 
      in 28% of the cases to continue the antibiotic therapy on an outpatient setting. 
      Patients were managed out of the hospital for 76% of the post-consolidation 
      neutropenia period. Thanks to the availability of an EU specifically dedicated to 
      outpatients with hematologic diseases, out-hospital management of APL patients 
      after consolidation therapy appeared to be safe, well accepted, potentially 
      cost-saving, and contributed to saving the risk of developing severe nosocomial 
      infections.
FAU - Girmenia, C
AU  - Girmenia C
AD  - Dipartimento di Biotecnologie Cellulari ed Ematologia, University La Sapienza, 
      Rome, Italy.
FAU - Latagliata, R
AU  - Latagliata R
FAU - Tosti, S
AU  - Tosti S
FAU - Morano, S G
AU  - Morano SG
FAU - Celesti, F
AU  - Celesti F
FAU - Coppola, L
AU  - Coppola L
FAU - Spadea, A
AU  - Spadea A
FAU - Breccia, M
AU  - Breccia M
FAU - Battistini, R
AU  - Battistini R
FAU - Tafuri, A
AU  - Tafuri A
FAU - Cimino, G
AU  - Cimino G
FAU - Mandelli, F
AU  - Mandelli F
FAU - Alimena, G
AU  - Alimena G
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Leukemia
JT  - Leukemia
JID - 8704895
RN  - 5688UTC01R (Tretinoin)
RN  - 75J73V1629 (Ceftriaxone)
RN  - 84319SGC3C (Amikacin)
RN  - ZRP63D75JW (Idarubicin)
RN  - AIDA protocol
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Ambulatory Care
MH  - Amikacin/therapeutic use
MH  - Anemia/etiology
MH  - Antineoplastic Combined Chemotherapy Protocols/administration & dosage/adverse 
      effects/*therapeutic use
MH  - Bacterial Infections/drug therapy/epidemiology/etiology
MH  - Ceftriaxone/therapeutic use
MH  - Cerebral Hemorrhage/etiology
MH  - Cross Infection/drug therapy/epidemiology/etiology/microbiology
MH  - Drug Therapy, Combination/therapeutic use
MH  - Emergency Service, Hospital/organization & administration/statistics & numerical 
      data
MH  - Female
MH  - Fever/epidemiology/etiology
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Idarubicin/administration & dosage/adverse effects
MH  - Incidence
MH  - Length of Stay/statistics & numerical data
MH  - Leukemia, Promyelocytic, Acute/complications/*drug therapy/mortality
MH  - Male
MH  - Middle Aged
MH  - Neutropenia/etiology
MH  - Remission Induction
MH  - Tretinoin/administration & dosage/adverse effects
EDAT- 1999/04/24 00:00
MHDA- 1999/04/24 00:01
CRDT- 1999/04/24 00:00
PHST- 1999/04/24 00:00 [pubmed]
PHST- 1999/04/24 00:01 [medline]
PHST- 1999/04/24 00:00 [entrez]
AID - 10.1038/sj.leu.2401375 [doi]
PST - ppublish
SO  - Leukemia. 1999 Apr;13(4):514-7. doi: 10.1038/sj.leu.2401375.