Early discharge after high dose chemotherapy is safe and feasible: a prospective evaluation of 6 years of home care

• Published in: Leukemia & lymphoma Vol. 56; no. 7; pp. 2098 - 2104
• Main Authors: Mank, Arno P. M., Schoonenberg, Charlot, Bleeker, Kim, Heijmenberg, Susanne, Heer, Koen de, van Oers, Marinus H. J., Kersten, Marie José
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 01.07.2015
• Subjects: Adult; Aged; ambulatory care; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Case-Control Studies; chemotherapeutic approaches; clinical results; Dose-Response Relationship, Drug; Feasibility Studies; Female; Follow-Up Studies; Hematologic Neoplasms - drug therapy; Hematologic Neoplasms - pathology; Home Care Services; Humans; Infectious complications; Male; Middle Aged; Neoplasm Staging; nursing; Patient Discharge; Patient Readmission - statistics & numerical data; Prognosis; Prospective Studies; Time Factors; chemotherapeutic approaches; Infectious complications; ambulatory care; nursing; clinical results
• ISSN: 1042-8194; 1029-2403
• DOI: 10.3109/10428194.2014.974039

A single-center, prospective, non-randomized clinical study was performed to examine the safety and feasibility of early discharge in patients undergoing consolidation chemotherapy for acute leukemia, or autologous stem cell transplant for lymphoma or multiple myeloma. Patients were discharged into ambulatory care the day after the last chemotherapy administration and were subsequently seen at the ambulatory care unit three times a week. One hundred and one of 224 patients were ineligible for the program, mostly because of their medical situation, the lack of a caregiver or the travel time to the hospital. The remaining 123 patients were able to spend more than 70% of the time at home. In 44% of cycles they were never readmitted. This study demonstrates the safety, feasibility and benefits of managing carefully selected patients. Patients and their caregivers felt safe and comfortable at home, and the vast majority preferred home care to in-hospital treatment.