At-Home Care Program for Acute Myeloid Leukemia Induction Phase in Patients Treated with Venetoclax-Based Low-Intensity Regimens
<b>Background:</b> Even though venetoclax in combination with azacitidine (VenAza) is considered a low-intensity regimen, its patients present a high incidence of cytopenia and infections during the first courses, making the initial management a challenging phase. <b>Methods:</b> This difficulty in our center led to the establishment of an At-Home (AH) program for ramp-up and follow-up patients during the VenAza combination induction phase focused on therapy administration, patient and caregiver education, and management of adverse events (AEs). A total of 70 patients with newly diagnosed acute myeloid leukemia (ND-AML) or relapsed/refractory AML (R/R AML) were treated with VenAza from March 2019 to May 2022. We compared outcomes between patients managed with a hospital-based (inpatient) approach and those managed through the AH program. <b>Results:</b> Despite most patients experiencing grade 3-4 cytopenias (96.9%), the incidence of serious infections and other AEs was comparable between both groups, with no significant difference in febrile neutropenia (42.3% vs. 27.8%, <i>p</i> = 0.38). Overall, the AH cohort demonstrated a significantly lower hospital readmission rate after ramp-up (29.5% vs. 84.6%, <i>p</i> = 0.001). Moreover, the inpatient cohort's admission days were longer than in the AH cohort (13 vs. 8, <i>p</i> = 0.28). <b>Conclusions:</b> AH management was feasible and safe, leading to better resource use, enhanced patient comfort, and improved treatment compliance. The potential of AH programs for managing low-intensity chemotherapy regimens can reduce hospital admissions and subsequently improve patient and caregiver well-being.
Authors
- Inés Zugasti (ORCID: https://orcid.org/0000-0002-7666-5055)
- Francesca Guijarro (ORCID: https://orcid.org/0000-0001-6376-0929)
- Beatriz Merchán
- Sandra Castaño‐Díez (ORCID: https://orcid.org/0000-0001-9044-4665)
- Esther Carcelero
- Alexandra Martínez‐Roca (ORCID: https://orcid.org/0000-0003-2143-5356)
- Jordi Esteve (ORCID: https://orcid.org/0000-0002-8056-648X)
- Carlos Jiménez‐Vicente (ORCID: https://orcid.org/0000-0002-9548-4305)
- A. Pérez Trigueros
- Luis Gerardo Rodríguez‐Lobato (ORCID: https://orcid.org/0000-0001-5694-0921)
- Nuria Ballestar (ORCID: https://orcid.org/0000-0001-7841-0171)
- Álex Bataller (ORCID: https://orcid.org/0000-0002-6085-2745)
- Helena Brillembourg
- Marina Díaz‐Beyá (ORCID: https://orcid.org/0000-0001-9624-2597)
- Francesc Fernández‐Avilés (ORCID: https://orcid.org/0000-0002-3733-590X)
- Amanda Isabel Pérez‐Valencia (ORCID: https://orcid.org/0000-0002-0072-5496)
- Albert Cortés‐Bullich (ORCID: https://orcid.org/0000-0002-6260-901X)
- Cristina Gallego (ORCID: https://orcid.org/0000-0002-1733-6067)
Institutions
- Hospital Clínic de Barcelona (ES)
- Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES)
- Universitat de Barcelona (ES)
Publication Details
- Journal
- Cancers
- Published
- 2024-12-23
- DOI
- https://doi.org/10.3390/cancers16244274
- Citations
- 1
- Primary Topic
- Acute Myeloid Leukemia Research
- Type
- article
- Field-Weighted Citation Impact
- 0.45