ASH Clinical News November 2015 | Page 45

CLINICAL NEWS Early Discharge Versus Inpatient Care for AML or MDS Patients For patients with acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS), induction therapy often requires patients to remain hospitalized until blood cell count recovery, typically resulting in prolonged hospitalization stays, increased health resource use, and increased costs. According to results from a study published in JAMA Oncology, outpatient management of these patients is a cost-effective approach – cutting daily costs by more than $2,000 – but early discharge carries with it a higher risk for certain complications. Outpatient management of AML and MDS patients cuts daily costs but carries a higher risk for certain complications. follow-up, securing a reliable caregiver, and residency within 60 minutes of the outpatient clinic) were selected for the outpatient management cohort. Twenty-nine patients who met the medical criteria but not the logistic criteria, served as inpatient controls. Patients remained on protocol until blood count recovery, additional chemo- LET HIM EXPLORE A NATURAL PATHWAY ELOCTATE, the first and only rFVIII that uses Fc fusion to prolong half-life Selected Important Safety Information • ELOCTATE is contraindicated in patients who have had life-threatening hypersensitivity reactions to ELOCTATE, including anaphylaxis Please see below for additional Important Safety Information and see full Brief Summary on the next page. GET TO KNOW ELOCTATE Fc FUSION ELOCTATE offers a prolonged half-life using one of the body’s NATURAL PATHWAYS1,2 Jennifer E. Vaughn, MD, from Fred Hutchinson Cancer Research Center in Seattle, Washington, and colleagues conducted a nonrandomized, phase II, single-center study at the University of Washington Medical Center to compare the safety, resource use, infections, and costs associated with inpatient versus outpatient chemotherapy in AML and MDS patients. From January 1, 2011, through July 31, 2014, the investigators enrolled 136 patients who received induction chemotherapy into the study. Those who met the designated medical and logistic criteria for early discharge following completion of induction chemotherapy (including ECOG performance status of 0-1 with adequate organ function and no active bleeding, agreeable to close outpatient Routine prophylaxis starting dosing interval of EVERY 4 DAYS* *Recommended prophylaxis starting dose of 50 IU/kg every 4 days, with adjustments based on patient response in the range of 25-65 IU/kg at 3- to 5-day intervals. More frequent or higher doses up to 80 IU/kg may be required in children <6 years of age. The one-stage clotting assay or chromogenic assay can be used to monitor plasma FVIII levels after administering ELOCTATE. rFVIII=recombinant Factor VIII. Indications and Important Safety Information INDICATIONS: ELOCTATE [Antihemophilic Factor (Recombinant), Fc Fusion Protein] is a recombinant DNA derived, antihemophilic factor indicated in adults and children with Hemophilia A (congenital Factor VIII deficiency) for: control and prevention of bleeding episodes, perioperative management (surgical prophylaxis), and routine prophylaxis to prevent or reduce the frequenc