학술논문
Treatment in patients with acute myeloid leukemia/high-risk myelodysplastic syndrome with hypomethylating agents: Day-hospital management compared to home care setting.
Document Type
Academic Journal
Author
Trapè G; Hematology Unit-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; De Angelis G; Hematology Unit-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; Morucci M; Hematology Unit-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; Tarnani M; Hematology Unit-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; De Gregoris C; Hematology Unit-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; Di Veroli A; Hematology Unit-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; Panichi V; Laboratory of Immunophenotyping-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; Topini G; Laboratory of Immunophenotyping-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; Bassi L; Laboratory of Medical Genetics-ASL Viterbo, Ospedale Belcolle, Viterbo, Italy.; Isidori R; Laboratory of Medical Genetics-ASL Viterbo, Ospedale Belcolle, Viterbo, Italy.; Poscente M; Laboratory of Medical Genetics-ASL Viterbo, Ospedale Belcolle, Viterbo, Italy.; Innocenti V; Hematology Unit-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; Cippitelli EE; Hematology Unit-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; Talucci R; Hematology Unit-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; Bertelli S; Hematology Unit-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; Crocicchia A; Hematology Unit-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; Lippi A; Hematology Unit-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; Pezzuti G; Hematology Unit-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; Fuschino M; Hematology Unit-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; Randi R; Hematology Unit-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; Mastini C; Hematology Unit-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; Ciambella S; Hematology Unit-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; Pessina G; Laboratory of Medical Genetics-ASL Viterbo, Ospedale Belcolle, Viterbo, Italy.; Montanaro M; Hematology Unit-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.; Latagliata R; Hematology Unit-ASL Viterbo, Belcolle Hospital, Viterbo, Italy.
Source
Publisher: Blackwell Country of Publication: England NLM ID: 8703985 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1600-0609 (Electronic) Linking ISSN: 09024441 NLM ISO Abbreviation: Eur J Haematol Subsets: MEDLINE
Subject
Language
English
Abstract
Objectives: Aim of the study was to evaluate the role of a Domiciliary Hematologic Care Unit (DHCU) compared to standard DH setting in the active frontline treatment with hypomethylating agents (HMAs) +/- venetoclax of frail patients with acute myelogenous leukemia/high-risk myelodysplastic syndromes (AML/HR-MDS).
Methods: All patients with newly diagnosed AML/HR-MDS unfit for intensive care and treated frontline with HMAs from January 2010 to April 2021 were retrospectively included.
Results: Among 112 patients (62 AML/50 HR-MDS), 69 (61.6%) were treated in a standard DH setting and 43 (38.4%) were followed by DHCU, allocated to DH or DHCU by responsible physician. Overall response rate was 29/69 (42.0%) in DH versus 19/43 (44.1%) in DHCU (p = .797). Median response duration was 8.7 months (95%CI 7.0-10.3) in DH versus 13.0 months (95%CI 8.3-17.6) in DHCU (p = .460). Infections were also equally reported. Median overall survival of patients treated in DH was 13.7 months (95%CI 9.9-17.4) compared to 13.0 months (95%CI 6.7-19.3) of patients managed by DHCU (p = .753).
Conclusions: Home care management of HMA is feasible and effective, with results similar to standard DH setting: this approach is thus adequate to offer active therapies in frail patients with AML/HR-MDS considered up to now ineligible.
(© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Methods: All patients with newly diagnosed AML/HR-MDS unfit for intensive care and treated frontline with HMAs from January 2010 to April 2021 were retrospectively included.
Results: Among 112 patients (62 AML/50 HR-MDS), 69 (61.6%) were treated in a standard DH setting and 43 (38.4%) were followed by DHCU, allocated to DH or DHCU by responsible physician. Overall response rate was 29/69 (42.0%) in DH versus 19/43 (44.1%) in DHCU (p = .797). Median response duration was 8.7 months (95%CI 7.0-10.3) in DH versus 13.0 months (95%CI 8.3-17.6) in DHCU (p = .460). Infections were also equally reported. Median overall survival of patients treated in DH was 13.7 months (95%CI 9.9-17.4) compared to 13.0 months (95%CI 6.7-19.3) of patients managed by DHCU (p = .753).
Conclusions: Home care management of HMA is feasible and effective, with results similar to standard DH setting: this approach is thus adequate to offer active therapies in frail patients with AML/HR-MDS considered up to now ineligible.
(© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)