Feasibility, safety and outcomes of patients with newly diagnosed acute myeloid leukemia discharged ‘early’ after intensive induction

Patients treated with intensive induction therapy for acute myeloid leukemia (AML) traditionally remain admitted until count recovery, however, select patients may be safe for 'early' discharge. We evaluated sequential patients with newly diagnosed AML treated with intensive induction at Yale Cancer Center from December 2016 to January 2024 and eligible for an early discharge program (EDP). Amongst 185 patients, 99 (53.5%) were discharged with an absolute neutrophil count (ANC) <0.5 x 10³/µL. An ANC ≤0.1 x 10³/µL at discharge (<i>N</i> = 54) was used to define patients furthest from hematologic recovery. These patients had fewer inpatient days accounting for re-admissions (23%) before count recovery (23.5 vs 28.0 days, <i>p</i> = 0.0003). Most readmissions (92%) were for febrile neutropenia and uncomplicated. Ultimately, there were no differences in 90-day mortality, or median overall survival between patients with ANC ≤0.1 x 10³/µL at discharge and non-EDP patients. An EDP is feasible and safe for select patients.