Treatment in patients with acute myeloid leukemia/high‐risk myelodysplastic syndrome with hypomethylating agents: Day‐hospital management compared to home care setting

Abstract Objectives Aim of the study was to evaluate the role of a Domiciliary Hematologic Care Unit (DHCU) compared to standard DH setting in the active frontline treatment with hypomethylating agents (HMAs) +/− venetoclax of frail patients with acute myelogenous leukemia/high‐risk myelodysplastic syndromes (AML/HR‐MDS). Methods All patients with newly diagnosed AML/HR‐MDS unfit for intensive care and treated frontline with HMAs from January 2010 to April 2021 were retrospectively included. Results Among 112 patients (62 AML/50 HR‐MDS), 69 (61.6%) were treated in a standard DH setting and 43 (38.4%) were followed by DHCU, allocated to DH or DHCU by responsible physician. Overall response rate was 29/69 (42.0%) in DH versus 19/43 (44.1%) in DHCU ( p = .797). Median response duration was 8.7 months (95%CI 7.0–10.3) in DH versus 13.0 months (95%CI 8.3–17.6) in DHCU ( p = .460). Infections were also equally reported. Median overall survival of patients treated in DH was 13.7 months (95%CI 9.9–17.4) compared to 13.0 months (95%CI 6.7–19.3) of patients managed by DHCU ( p = .753). Conclusions Home care management of HMA is feasible and effective, with results similar to standard DH setting: this approach is thus adequate to offer active therapies in frail patients with AML/HR‐MDS considered up to now ineligible.