Description:
The availability of multiple new therapeutic options has led to fundamental shift in the treatment landscape of acute leukemias. With the availability of new oral agents and parenteral drugs suitable for outpatient administration, especially in acute myeloid leukemia (AML), there is increased interest in treating acute leukemia patients in the community rather than referring them to academic centers. Thus, this education session will explore best practices for treating acute leukemia patients in the community, in which situations these patients should be referred for treatment, or co-management, at academic centers, and provide an update on issues in infection prophylaxis and treatment.

First, Dr. Halpern will discuss practice patterns and outcomes for patients treated in the community compared with academic centers and examine potential reasons for differences in outcomes. She will review which specific patient subgroups might benefit most from treatment at academic centers, and finally will explore how expanding diagnostic methods and the changing therapeutic landscape in AML might affect differences in patient outcomes at different types of institutions.

Dr Jillella will then discuss the importance of community hospitals in the management of patients with acute leukemia. She will discuss the role of community and academic collaboration as an additional step to improving patient outcomes in the community and will also explore the barriers to clinical trials in the community and a collaborative means to improve accrual.

Finally, Dr. Taplitz will review important issues in prophylaxis and treatment of infections in patients with acute leukemia in the community, with a special focus on newer data on antimicrobial prophylaxis, treatment of febrile neutropenia including de-escalation of antibiotics, and infection risk with some of the newer therapies for treatment of leukemia.