OUTPATIENT SUPPORTIVE THERAPY AFTER INDUCTION TO REMISSION THERAPY INADULT ACUTE MYELOGENOUS LEUKEMIA (AML) IS FEASIBLE - A MULTICENTER STUDY

Twenty-four adult patients with AML were treated with standard ''''7 3'''' chemotherapy. After administering the myeloablative drugs in th e hospital, patients were instructed to continue their supportive trea tment on an outpatient basis; they received ciprofloxacin, cotrimoxaso le and itraconazole vo until the absolute granulocyte count rose above 1 x 10(9)/1. Platelet concentrates were given every other day until t he platelet count rose above 20 x 10(9)/1. Complete remission (CR) was obtained in 87%. Fever developed in 29% and 2 cases were complicated by indwelling-catheter-related Pseudomona aeruginosa septicaemia, 1 En tamoeba hystolytica enteritis and 1 Pneumocystis carinii pneumonia; th ese patients were hospitalized to treat these infections specifically. In no case was the infection fatal. The median disease free-survival (DFS) was 17 months, 12-month DFS was 66%, and 30-month DFS was 17%. O ur calculations have shown that 1700 USD/patient were saved by avoidin g prolonged hospitalization; this may provide not only economical, but also psychological advantages to patients.