Early Discharge and Outpatient Care After Chemotherapy in Patients With Myelodysplastic Syndrome or Acute Myeloid Leukemia
Condition: Leukemia; Myelodysplastic Syndromes
MeSH terms: Leukemia; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Preleukemia; Myelodysplastic Syndromes; Syndrome
Study type: Interventional

Summary: 
      RATIONALE: Gathering information about patients with myelodysplastic syndrome or acute
      myeloid leukemia who are discharged after finishing chemotherapy, or who stay in the hospital
      until blood counts return to normal, may help doctors learn more about a patient's quality of
      life, use of medical services, and the cost of these services.

      PURPOSE: This clinical trial is studying early discharge and outpatient care in patients who
      have undergone chemotherapy for myelodysplastic syndrome or acute myeloid leukemia.
    

Detailed description: 
      OBJECTIVES:

      Primary

        -  To compare the death rate in patients with myelodysplastic syndromes or acute myeloid
           leukemia who are discharged after completion of induction chemotherapy vs those who
           remain in the hospital until blood counts recover.

      Secondary

        -  To determine the proportion of patients who meet the early discharge criteria after
           completion of induction chemotherapy.

        -  To compare the costs incurred by patients who are discharged early vs those who are
           discharged only after blood counts recover.

        -  To compare resource utilization (e.g., transfusions) among these patients.

        -  To compare the quality of life of these patients.

      OUTLINE: Within 72 hours after completion of induction chemotherapy, patients are either
      discharged from the hospital or remain in the hospital until their blood counts recover.

      Patients receive standard supportive care after completion of induction chemotherapy either
      in the hospital or as an outpatient. Outpatients are seen by a registered nurse or physician
      assistant ≥ 3 times weekly and by a physician at least once weekly.

      A medical chart review is conducted to obtain information about medical complications (e.g.,
      neutropenic fever, documented infections, bleeding, reasons for hospitalization) and use of
      medical resources. Patients complete the MDA Symptom Inventory and the EORTC QLQ-C30
      questionnaire periodically to assess quality of life. Costs associated with inpatient and
      outpatient care are evaluated using electronic billing information from the University of
      Washington Medical Center and Seattle Cancer Care Alliance.

      After completion of the study, patients are followed up for 1 month.
    

Intervention name(s): medical chart review; questionnaire administration; quality-of-life assessment
Intervention type(s): Other; Other; Procedure
Primary purpose: Health Services Research
Keywords: de novo myelodysplastic syndromes; previously treated myelodysplastic syndromes; secondary myelodysplastic syndromes; recurrent adult acute myeloid leukemia; untreated adult acute myeloid leukemia; adult acute myeloid leukemia with inv(16)(p13;q22); adult acute myeloid leukemia with t(16;16)(p13;q22); adult acute myeloid leukemia with t(8;21)(q22;q22); adult acute myeloid leukemia with 11q23 (MLL) abnormalities; adult acute minimally differentiated myeloid leukemia (M0); adult acute myeloblastic leukemia without maturation (M1); adult acute myeloblastic leukemia with maturation (M2); adult acute myelomonocytic leukemia (M4); adult acute monoblastic leukemia (M5a); adult acute eosinophilic leukemia; adult acute monocytic leukemia (M5b); adult acute megakaryoblastic leukemia (M7); adult acute basophilic leukemia; acute myeloid leukemia with multilineage dysplasia following myelodysplastic syndrome; adult erythroleukemia (M6a); adult pure erythroid leukemia (M6b)