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Infections are responsible for most treatment-related morbidity and mortality in pediatric acute myeloid leukemia (AML). Children’s Oncology Group (COG) recommends hospitalization following chemotherapy until early absolute neutrophil count (ANC) recovery. No standard guidelines exist for antibiotic prophylaxis and discharge practices vary. Our objective was to report our institution’s experience with outpatient supportive care management following early discharge. A retrospective chart review of pediatric AML patients treated at our institution from 2010 to 2019 was conducted. Data was collected on length of hospitalization, antibiotics administered, infections, and neutropenia duration. Seventeen patients underwent 60 chemotherapy cycles. All were discharged after completion of chemotherapy if clinically stable. Patients were re-admitted for fever and discharged on empiric antibiotics if afebrile with negative cultures. Prophylactic antibiotics were administered in 55 cycles. There were 12 infections in 11 patients and no deaths due to infection. Patients remained outpatient for a mean of 15.8 neutropenia days per cycle. Outpatient supportive care for children with AML may be feasible and safe. Further studies are needed to establish outpatient supportive care guidelines.
Renee Potashner; Mark E. Weinblatt; Chana L. Glasser. Outpatient supportive care for pediatric acute myeloid leukemia: a single institution’s experience. Pediatric Hematology and Oncology 2021, 1 -10.
AMA StyleRenee Potashner, Mark E. Weinblatt, Chana L. Glasser. Outpatient supportive care for pediatric acute myeloid leukemia: a single institution’s experience. Pediatric Hematology and Oncology. 2021; ():1-10.
Chicago/Turabian StyleRenee Potashner; Mark E. Weinblatt; Chana L. Glasser. 2021. "Outpatient supportive care for pediatric acute myeloid leukemia: a single institution’s experience." Pediatric Hematology and Oncology , no. : 1-10.
The relapse rate for children with acute myeloid leukemia (AML) remains high despite advancements in risk classification, multi-agent chemotherapy intensification, stem cell transplantation, and supportive care guidelines. Prognosis for this subgroup of children with relapsed/refractory AML remains poor. It is well known that the ceiling of chemotherapy intensification has been reached, limited by acute and chronic toxicity, necessitating alternative treatment approaches. In the last several years, our improved understanding of disease biology and critical molecular pathways in AML has yielded a variety of new drugs to target these specific pathways. This review provides a summary of antibody drug conjugates (ADCs), small molecule inhibitors, and tyrosine kinase inhibitors with an emphasis on those that are currently under clinical evaluation or soon to open in early phase trials for children with relapsed/refractory AML.
Jing Chen; Chana Glasser. New and Emerging Targeted Therapies for Pediatric Acute Myeloid Leukemia (AML). Children 2020, 7, 12 .
AMA StyleJing Chen, Chana Glasser. New and Emerging Targeted Therapies for Pediatric Acute Myeloid Leukemia (AML). Children. 2020; 7 (2):12.
Chicago/Turabian StyleJing Chen; Chana Glasser. 2020. "New and Emerging Targeted Therapies for Pediatric Acute Myeloid Leukemia (AML)." Children 7, no. 2: 12.