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丹麦全国性概念验证研究:急性髓细胞白血病患者家庭为基础的强化化疗的可行性和安全性。

A national Danish proof of concept on feasibility and safety of home -based intensive chemotherapy in patients with acute myeloid leukemia.

机构信息

Department of Haematology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.

Amgros, Dampfærgevej 22, 2100, Copenhagen Ø, Denmark.

出版信息

Leuk Res. 2022 Jan;112:106756. doi: 10.1016/j.leukres.2021.106756. Epub 2021 Nov 22.

DOI:10.1016/j.leukres.2021.106756
PMID:34839055
Abstract

Technological advances have made it possible to offer home-based chemotherapy to patients without health care professionals being present. Prior studies on effects of home-based treatment lack inclusion of patients with hematologic malignancies. We present data from a multicenter single-arm feasibility and safety study of home-based intensive chemotherapy in patients with newly diagnosed acute myeloid leukemia and their quality of life and psychological wellbeing. This national study included patients from six sites in Denmark who received intensive chemotherapy on programmed CADD Solis infusion pumps through a central venous catheter and were also managed as outpatients during treatment-induced pancytopenia. Data are presented from 104 patients, receiving 272 treatments with 1.096 (mean 4.57, SD 3.0) home infusion days out of 1.644 treatment days (67 %). Sixty-two of 168 (36.9 %) reinduction and consolidation treatment cycles ensuing pancytopenia phases were solely handled in the outpatient clinic. Patients reported high satisfaction with home-based treatment, which had a positive influence on their ability to be involved in their treatment and be socially and physically active. No unexpected events occurred during the intervention. Overall, patients improved in all quality of life outcomes over time. Home-based intensive chemotherapy treatment was feasible and safe in this population. ClinicalTrials.gov identifier: NCT04904211.

摘要

技术进步使得在没有医疗保健专业人员在场的情况下为患者提供家庭化疗成为可能。之前关于家庭治疗效果的研究缺乏对血液系统恶性肿瘤患者的纳入。我们报告了一项多中心、单臂可行性和安全性研究的数据,该研究评估了新诊断的急性髓系白血病患者家庭强化化疗及其生活质量和心理幸福感。这项全国性研究纳入了丹麦六个地点的患者,他们通过中央静脉导管接受计划 CADD Solis 输注泵的强化化疗,并在治疗诱导的全血细胞减少期间作为门诊患者进行管理。研究共纳入了 104 名患者,共接受了 272 次治疗,其中 1.096 天(平均 4.57,SD 3.0)在家中进行输液,1644 天(67%)中有 1.644 天在门诊进行治疗。在随后的全血细胞减少期,168 个再诱导和巩固治疗周期中有 62 个(36.9%)仅在门诊进行处理。患者报告对家庭治疗非常满意,这对他们参与治疗和保持社交和身体活跃的能力产生了积极影响。在干预过程中没有发生意外事件。总体而言,患者的所有生活质量指标都随着时间的推移而改善。在该人群中,家庭强化化疗是可行和安全的。临床试验注册号:NCT04904211。

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