Patient Centered Outcomes Research Institute (PCORI) Study: Home or Away from Home
Acute lymphoblastic leukemia (ALL) is the second most common pediatric hematologic malignancy. While it accounts for only about 20% of leukemias in children, it is responsible for more than half of leukemia deaths. Each treatment course results in a period of prolonged neutropenia during which patients are highly susceptible to severe infection, a major cause of therapy-related morbidity and mortality in children with AML. Although pediatric cancer supportive care guidelines recommend that patients remain hospitalized until resolution of neutropenia, some hospitals discharge the majority of patients to outpatient management during neutropenia after chemotherapy. Other hospitals strictly utilize inpatient management. There is limited literature on the clinical consequences of outpatient versus inpatient management, making it difficult to determine the best way to manage a patient's neutropenic period in regards to their quality of life and clinical outcomes.
I will provide research support to a study aimed at comparing important clinical outcomes, including the occurrence of infection and treatment delays, for outpatient relative to inpatient management by abstracting relevant data from the medical charts of patients at pediatric hospitals around the country. The results of the study will provide a more complete risk-benefit profile to inform physicians, patients and caregivers in their selection of the most appropriate strategy of neutropenia management.