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We recently reported an early hospital discharge (EHD) care strategy following intensive acute myeloid leukemia (AML)-like chemotherapy is safe. To evaluate its impact on infectious outcomes, we compared all adults treated from 8/1/2014 to 7/31/2018 discharging within 72 h of completing chemotherapy (EHD) with hospitalized patients (controls) across 354 induction and 259 post-remission cycles. While overall outcomes were similar, gram-positive bacteremias were more common in EHD patients than control ( p &lt;.001), although they received fewer days of IV antimicrobials ( p &lt; .001). Notably, cumulative infection risks in EHD patients were similar after induction and post-remission therapy. In multivariable analysis, only EHD status was independently associated with risk for gram-positive bacteremia ( p = .01), whereas the only independent risk factor for fungal infection was fluconazole ( vs.  posaconazole) use ( p &lt; .001). The observation of increased rates of gram-positive bacteremias with EHD identifies improvements in catheter management as one area to further increase the safety of this care approach.

leukemia and lymphoma

Comparative analysis of infectious complications with outpatient  vs.  inpatient care for adults with high-risk myeloid neoplasm receiving intensive induction chemotherapy