Length of Stay for Acute Myelocytic Leukemia – pro
Standard therapy of of acute myelogenous leukemia (excluding acute promyelocytic leukemia).
Induction therapy: Various acceptable induction regimens are available. The most common approach is called ”3 and 7,” which consists of 3 days of a 15- to 30-minute infusion of an anthracycline (idarubicin or daunorubicin) or anthracenedione (mitoxantrone), combined with 100 mg/m2 of arabinosylcytosine (araC) as a 24-hour infusion daily for 7 days. Idarubicin is given at a dose of 12 mg/m2/d for 3 days, daunorubicin at 45-60 mg/m2/d for 3 days, or mitoxantrone at 12 mg/m2/d for 3 days. Using these regimens, approximately 50% of patients achieve remission with one course. Another 10-15% enter remission following a second course of therapy. Alternatively, high-dose araC combined with idarubicin, daunorubicin, or mitoxantrone can be used as induction therapy in younger patients. The use of high-dose araC outside the setting of a clinical trial is considered controversial.
The usual length of stay incorporates the days for infusion as well as to treat the sequellae of tehrapy that begin to onset at about a week later. These include pancytopenia, bleeding, infection and others. For this reason it is standard to continue inpatient care and to also isolate these patietns tp prevent infection, until hematologic recovery. Recovery takes at least 2 weeks and longer, if remission has not been achieved and the patient receives a second induction. Average length of stay for acute myelocytic leukemia ranges between 17 and 25 days in the USA.
There are major centers that have experimented with outpatient care in a nearby hotel facility but this requires a specialized program and is not routine.
Estey EH. Therapeutic options for acute myelogenous leukemia.Cancer. 2001 Sep 1;92(5):1059-73.