Background:Even though venetoclax in combination with azacitidine (VenAza) is considered a low-intensity regimen, its patients present a high incidence of cytopenia and infections during the first courses, making the initial management a challenging phase.Methods:This difficulty in our center led to the establishment of an At-Home (AH) program for ramp-up and follow-up patients during the VenAza combination induction phase focused on therapy administration, patient and caregiver education, and management of adverse events (AEs). A total of 70 patients with newly diagnosed acute myeloid leukemia (ND-AML) or relapsed/refractory AML (R/R AML) were treated with VenAza from March 2019 to May 2022. We compared outcomes between patients managed with a hospital-based (inpatient) approach and those managed through the AH program.Results:Despite most patients experiencing grade 3–4 cytopenias (96.9%), the incidence of serious infections and other AEs was comparable between both groups, with no significant difference in febrile neutropenia (42.3% vs. 27.8%,p= 0.38). Overall, the AH cohort demonstrated a significantly lower hospital readmission rate after ramp-up (29.5% vs. 84.6%,p= 0.001). Moreover, the inpatient cohort’s admission days were longer than in the AH cohort (13 vs. 8,p= 0.28).Conclusions:AH management was feasible and safe, leading to better resource use, enhanced patient comfort, and improved treatment compliance. The potential of AH programs for managing low-intensity chemotherapy regimens can reduce hospital admissions and subsequently improve patient and caregiver well-being.
背景：尽管维奈克拉联合阿扎胞苷（VenAza）被视为低强度治疗方案，但患者在前几个疗程中仍表现出较高的血细胞减少和感染发生率，使得初始管理阶段极具挑战性。 方法：针对这一难题，本中心建立了针对VenAza联合诱导阶段患者的居家管理计划，重点关注治疗实施、患者及照护者教育以及不良事件管理。2019年3月至2022年5月期间，共70例新诊断急性髓系白血病或复发/难治性急性髓系白血病患者接受VenAza治疗。我们比较了采用院内住院管理模式与居家管理计划患者的临床结局。 结果：尽管绝大多数患者出现3-4级血细胞减少（96.9%），但两组间严重感染及其他不良事件发生率相当，发热性中性粒细胞减少症发生率无显著差异（42.3% vs. 27.8%，p=0.38）。总体而言，居家管理组在剂量递增期后的再住院率显著更低（29.5% vs. 84.6%，p=0.001）。此外，住院组的总住院天数长于居家管理组（13天 vs. 8天，p=0.28）。 结论：居家管理模式安全可行，能够优化医疗资源利用、提升患者舒适度并改善治疗依从性。该模式在管理低强度化疗方案方面具有减少住院次数、提升患者及照护者生活质量的潜力。
肿瘤(癌症)患者之家