Safety of Early Discharge after High-dose Ara C Consolidation

Omyma Elemam; Syed Z Zaidi; Abdulaziz Al-Humaidi; Basim AlBeirouti; Ali Al-Shanqeeti

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ORIGINAL ARTICLE

Year : 2012 | Volume : 3 | Issue : 2 | Page : 67-70

Safety of Early Discharge after High-dose Ara C Consolidation

Omyma Elemam¹, Syed Z Zaidi², Abdulaziz Al-Humaidi², Basim AlBeirouti³, Ali Al-Shanqeeti⁴
¹ Oncology Center, King Abdullah Medical City, Makkah, Kingdom of Saudi Arabia, Medical Oncology, Oncology Center, Mansoura University, Mansoura, Egypt
² Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia P.O Box 59046, Riyadh 11525, Saudi Arabia
³ Oncology unit, King Abulaziz university Hospital, Jeddah, Saudi Arabia P.O Box 80215, Jeddah 21589, Saudi Arabia
⁴ National Center for Biotechnology, King Abdulaziz City for Science and Technology, King Abdullah Road, Building 17, Second Floor, Riyadh, Saudi Arabia

Correspondence Address:
Ali Al-Shanqeeti
National Center for Biotechnology, King Abdulaziz City for Science and Technology, King Abdullah Road, Building 17, Second Floor, Riyadh
Saudi Arabia

Source of Support: None, Conflict of Interest: None

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To assess the safety of early discharge of patients after receiving high dose Ara-C (HiDAC) consolidation for acute leukemia. Sixty five leukemic patients who had achieved complete remission and received 96 cycles of HiDAC between 2005 and 2010 were divided into 3 groups and their outcomes compared in terms of length of hospitalization and incidence and type of infections. Group I (12 patients) received HiDAC (total of 17 cycles) and stayed in the hospital after HIDAC until absolute neutrophil count (ANC) recovery, group II (23 patients) received HiDAC (total of 35 cycles) then were immediately discharged without antimicrobial or granulocyte colony stimulating factor (G-CSF) prophylaxis and group III (30 patients) received HiDAC (total of 44 cycles) then were immediately discharged but were prescribed antimicrobial and granulocyte colony stimulating factor (G-CSF) prophylaxis. Total number of hospitalization days and types of infection were recorded for all patients. Patients in group II required re-admission for febrile neutropenia (FN) during 33 cycles (94.3%) and for severe thrombocytopenia during 2 cycles (5.7%) with a median duration of inpatient hospitalization of 15 days. One patient in this group developed septic shock and required 4 days of ICU admission. Patients in group III did not develop FN during 21 cycles (47.7%) and had FN in 23 cycles (52.2 %) which required re-admission for a median of 8 days. Patients in group I had FN in 11 cycles (64.7%) while in the hospital. The differences in inpatient hospital length of stay & FN incidence were statistically significant among the 3 groups (p<0.001 and p=0.005 respectively). Conclusion: Early discharge with antimicrobial and G-CSG prophylaxis after HiDAC for acute leukemia is safe and feasible and may potentially save valuable resources by shortening the duration of inpatient hospital stay.

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