title: Postinduction Supportive Care of Pediatric Acute Myelocytic Leukemia: Should Patients be Kept in the Hospital?
abstract: Children with AML become profoundly neutropenic while they undergo remission induction chemotherapy. It is unknown whether these children should be kept in the hospital while they are severely neutropenic to prevent life-threatening complications associated with neutropenia and reduce fatality. We at our institution routinely discharge patients after completing remission induction chemotherapy in the presence of profound neutropenia, unless it is clinically contraindicated. We reviewed all AML patients who were consecutively treated at our hospital from 1989 to 2011. Thirteen patients were electively discharged after completion of induction I chemotherapy. Of the 13, 4 died due to relapse or complications of stem cell transplants (not due to neutropenia related complications). Another eight are long term survivors. In this very small series, discharge from the hospital even though patients were severely neutropenic did not adversely affect the survival.
authors.affiliation: Hurley Children's Hospital and Hurley Medical Center, One Hurley Plaza, Flint, MI 48503, USA ; Department of Pediatrics/Human Development, Michigan State University College of Human Medicine, One Hurley Plaza, Flint, MI 48503, USA.
authors.forename: Susumu
authors.initials: S
authors.lastname: Inoue
authors.affiliation: Hurley Children's Hospital and Hurley Medical Center, One Hurley Plaza, Flint, MI 48503, USA.
authors.forename: Isra'a
authors.initials: I
authors.lastname: Khan
authors.affiliation: Hurley Children's Hospital and Hurley Medical Center, One Hurley Plaza, Flint, MI 48503, USA.
authors.forename: Rao
authors.initials: R
authors.lastname: Mushtaq
authors.affiliation: Hurley Children's Hospital and Hurley Medical Center, One Hurley Plaza, Flint, MI 48503, USA.
authors.forename: Dawn
authors.initials: D
authors.lastname: Carson
authors.affiliation: Hurley Children's Hospital and Hurley Medical Center, One Hurley Plaza, Flint, MI 48503, USA ; Department of Pediatrics/Human Development, Michigan State University College of Human Medicine, One Hurley Plaza, Flint, MI 48503, USA.
authors.forename: Elna
authors.initials: E
authors.lastname: Saah
authors.affiliation: Hurley Children's Hospital and Hurley Medical Center, One Hurley Plaza, Flint, MI 48503, USA ; Department of Pediatrics/Human Development, Michigan State University College of Human Medicine, One Hurley Plaza, Flint, MI 48503, USA.
authors.forename: Nkechi
authors.initials: N
authors.lastname: Onwuzurike