Home or Away From Home: Comparing Clinical Outcomes Relevant to the Care of Pediatric Acute Myeloid Leukemia During Periods of Neutropenia
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 610
- 试验地点
- 17
- 主要终点
- Occurrence of Post-chemotherapy Bacteremia
研究概览
简要总结
Treatment for pediatric acute myeloid leukemia (AML) involves intensive chemotherapy regimens that result in periods of profound neutropenia leaving patients susceptible to severe infectious complications. Infectious complications are the leading cause of treatment related mortality among AML patients, but there are little clinical data to inform whether management of neutropenia post AML chemotherapy should occur in an outpatient or inpatient setting. The primary objective of this study is to compare the clinical effectiveness of outpatient versus inpatient management of neutropenia in children with AML.
详细描述
This is a bidirectional observational cohort study.
Participants will be patients less that 19 years of age at diagnosis receiving or having received chemotherapy for AML from seventeen participating pediatric hospitals across the United States. There is no study intervention; this is a medical record abstraction study only. Investigators will abstract subjects medical record data over the study period in order to study clinical outcomes including the occurrence of bacteremia and time to the start of the next course in the chemotherapy regimen, in relation to neutropenia management strategy.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Other
入排标准
- 年龄范围
- — 至 19 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Males or females of age less than 19 at diagnosis.
- •Receipt or planned receipt of AML chemotherapy between January 1, 2012 and December 31, 2019.
排除标准
- •Patients being treated for relapsed AML
- •Patients with Acute Promyelocytic Leukemia (APML)
- •Patients undergoing stem cell transplant (SCT)
- •Patients receiving reduced intensity frontline chemotherapy
结局指标
主要结局
Occurrence of Post-chemotherapy Bacteremia
时间窗: Identification of bacteremia will begin three days after completion of a chemotherapy course and will continue until recovery of absolute neutrophil count (ANC > 200 uL), or until the start of the next course.
Identification of bacteremia will begin three days after completion of a chemotherapy course and will continue until recovery of absolute neutrophil count (ANC \> 200 uL), or until the start of the next course (for a very small number of patients who begin the next course of chemotherapy prior to count recovery). Bacteremia will be defined as a single positive blood culture for a bacterial pathogen (including Viridans group Streptococci). If the bacterium is an organism considered as a common commensal organism by the National Healthcare Safety Network, two separate positive blood cultures will be required for classification as bacteremia.
次要结局
- Time to the Initiation of the Next Chemotherapy Course(The number of days from the three days after the completion chemotherapy in a given course until the first day of the next course)