© 2005 European Society for Medical Oncology
Original article |
Home care versus hospital care of patients with hematological malignancies and chemotherapy-induced cytopenia
1 Department of Medical Microbiology, 2 Department of Clinical Epidemiology and Medical Technology Assessment, 3 Department of Internal Medicine, Division of Hematology/Oncology, University Hospital Maastricht, The Netherlands
* Correspondence to: Dr F. H. van Tiel, Department of Medical Microbiology, University Hospital of Maastricht, P. Debyelaan 25, 6202 AZ Maastricht, The Netherlands. Tel: +31-43-3874643; Fax: +31-43-3876643; Email: fvt{at}lmib.azm.nl
Background: The purpose of this review study is to examine the accumulating evidence of safety of home care, with regard to infection-related morbidity and mortality, for patients with chemotherapy-induced cytopenia, in light of previous studies on the necessity of protective isolation (PI).
Patients and methods: The existing literature on PI, and home care of cytopenic patients after chemotherapy, published in the English language, based on a Medline search, is reviewed.
Results: The studies published so far on home care versus hospital care are all non-randomized studies and confirm that home care of cytopenic patients is safe, in terms of morbidity and mortality due to infections. On the other hand, the majority of studies on the comparison of PI with standard hospital care conclude that an infection-preventive effect of PI exists. The pooled statistics performed confirmed that such an effect of PI exists regarding the occurrence of severe infections, although no benefit to mortality has been shown.
Conclusions: Regarding home care, only the results of a prospective, randomized study of sufficient power will enable definitive conclusions to be drawn as to whether home care is equally safe as hospital-based care with PI.
Key words: chemotherapy, cytopenia, home care, infection prevention, protective isolation
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  T. Halim, K. Song, M. Barnett, D. Forrest, D. Hogge, S. Nantel, T. Nevill, J. Shepherd, C. Smith, H. Sutherland, et al. Positive impact of selective outpatient management of high-risk acute myelogenous leukemia on the incidence of septicemia Ann. Onc., July 1, 2007; 18(7): 1246 - 1252. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Fernandez-Aviles, E. Carreras, A. Urbano-Ispizua, M. Rovira, C. Martinez, A. Gaya, M. Granell, L. Ramiro, C. Gallego, A. Hernando, et al. Case-Control Comparison of At-Home to Total Hospital Care for Autologous Stem-Cell Transplantation for Hematologic Malignancies J. Clin. Oncol., October 20, 2006; 24(30): 4855 - 4861. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. C. Schouten Home treatment for intensive hematological therapies: who will benefit? Ann. Onc., May 1, 2006; 17(5): 731 - 732. [Full Text] [PDF]
|
|
|
|
|
|
M. L. Savoie, T. J. Nevil, K. W. Song, D. L. Forrest, D. E. Hogge, S. H. Nantel, J. D. Shepherd, C. A. Smith, H. J. Sutherland, C. L. Toze, et al. Shifting to outpatient management of acute myeloid leukemia: a prospective experience Ann. Onc., May 1, 2006; 17(5): 763 - 768. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Shimabukuro-Vornhagen, H. Haverkamp, A. Engert, L. Balleisen, P. Majunke, G. Heil, H. T. Eich, H. Stein, V. Diehl, and A. Josting Lymphocyte-Rich Classical Hodgkin's Lymphoma: Clinical Presentation and Treatment Outcome in 100 Patients Treated Within German Hodgkin's Study Group Trials J. Clin. Oncol., August 20, 2005; 23(24): 5739 - 5745. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. V. Kern Outpatient management in patients with neutropenia after intensive chemotherapy--is it safe? Ann. Onc., February 1, 2005; 16(2): 179 - 180. [Full Text] [PDF]
|
|