Palmer P, Meyers F J
Department of Hematology and Oncology, University of California Davis, Medical Center, Sacramento.
Oncol Nurs Forum. 1990 Jul-Aug;17(4):553-8.
Consolidation chemotherapy (CT) is important in the curative treatment of acute lymphoblastic leukemia (ALL). This therapy is intensive and toxic. Usually, more than 50% of the treatment period is spent in the hospital. To determine if CT could be given safely as outpatient (OP) treatment, this demonstration project included strict patient selection criteria, a multidisciplinary team, and protocols for teaching, symptom management, and transfusion support. Patients were hospitalized for the first course of CT. A right atrial catheter was placed, and patients were taught use of an ambulatory infusion pump and CT administration. Two patients treated on Southwest Oncology Group protocol 8417/19 have completed CT. No infections occurred, and patients had minimal CT side effects. Both patients experienced neutropenia, an expected complication, for 80 and 56 days. With careful patient selection and expert nursing support, intensive outpatient CT is possible with decreased hospitalizations and morbidity, and possible increased quality of life.
巩固化疗（CT）在急性淋巴细胞白血病（ALL）的根治性治疗中至关重要。这种疗法强度大且有毒性。通常，超过50%的治疗期是在医院度过的。为了确定CT是否可以作为门诊（OP）治疗安全进行，这个示范项目包括严格的患者选择标准、多学科团队以及教学、症状管理和输血支持方案。患者在CT的第一个疗程时住院。放置了右心房导管，并教患者使用便携式输液泵和进行CT给药。两名按照西南肿瘤协作组方案8417/19治疗的患者已完成CT。未发生感染，患者的CT副作用最小。两名患者均出现了中性粒细胞减少，这是一种预期的并发症，分别持续了80天和56天。通过仔细选择患者和专家护理支持，强化门诊CT治疗是可行的，可减少住院次数和发病率，并可能提高生活质量。
