AML-225: Identification of Predictors for Uncomplicated, Low-Risk Febrile Neutropenia (FN) Admissions for Patients with Acute Myeloid Leukemia (AML) Following Intensive Chemotherapy

Abstract

Context Prolonged hospitalizations for AML patients impair quality of life and drive leukemia care costs. Febrile neutropenia (FN) is the most common reason for re-hospitalization in AML as current algorithms call for rapid administration of IV antimicrobials and close monitoring. Whether this approach is justified in all situations is unclear given availability of novel oral broad-spectrum antimicrobials and home drug infusion services. While FN risk models have been developed focusing on solid tumors, factors predicting uncomplicated courses of FN in AML patients, which might allow the identification of patients suitable for outpatient management, have not been studied. Objective To identify factors to that define a low-risk population of AML patients admitted for FN. Methods We retrospectively reviewed medical records for adults admitted for FN (temperature ≥38.3°C and absolute neutrophil count 1 admission) assessed covariate associations with discharge. Results We identified 250 FN admissions in 129 AML patients from 7/29/14–6/26/19. Thirty-three (13%) admissions were Conclusions Only 13% of AML admissions for FN were short and uncomplicated. Factors that predicted more severe outcomes in solid malignancies did not individually predict such outcomes for AML patients; however, a model of combined risk factors resulted in a moderate-high predictive ability for a “low-risk” admission. Funding This work was made possible by generous support from the James Chung Yam Lee Pilot Award.