{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:13:04Z","timestamp":1792782784628,"version":"4.5.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Karolinska Institute","id":[{"id":"https:\/\/ror.org\/056d84691","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Support Care Cancer"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Patients with acute myeloid leukemia (AML) spend a substantial amount of time in hospital while receiving intensive chemotherapy, affecting their quality of life and healthcare costs. This study evaluated the safety of outpatient management of febrile neutropenia with support from hospital at home (HaH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      Two cohorts of intensively treated patients with AML were retrospectively compared, one from Stockholm (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009116) with access to HaH and another from Gothenburg (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200949) without HaH support. Primary outcome was incidence of severe complications, defined as death or requirement of  higher level of\u00a0care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During cycle 1 (C1), 109 of 116 patients (94%) in Stockholm were discharged, of whom 50 (46%) were readmitted. In Gothenburg, 48 of 49 patients (98%) remained in hospital for the entirety of the neutropenic phase. The incidence of severe complications, including fatal events and requirement of higher level of care, was comparable in the two cohorts. Out of 150 neutropenic episodes (during C1 and C2) among discharged Stockholm patients, febrile neutropenia developed in 130 cases (86.7%). Of these, 38 episodes (29%) were resolved with administration of antibiotics at home only.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings demonstrate that outpatient management of AML patients treated with intensive chemotherapy is feasible and safe when supported by a structured HaH program in close collaboration with the hematology department. Implementation of at-home care has the potential to reduce the burden of prolonged periods of hospitalization for patients with AML and warrants further evaluation in prospective trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00520-026-11171-2","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T14:13:50Z","timestamp":1789049630000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hospital at home enables safe and efficient outpatient management of intensively treated acute myeloid leukemia"],"prefix":"10.1007","volume":"34","author":[{"given":"Kristina","family":"Warol\u00e9n","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"Blennow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Ravn Landtblom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christer","family":"Nilsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linus","family":"Kull\u00e4nger Schalling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Andersson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Lind","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"H\u00e5llander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Westerberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann-Sofie","family":"Stjernfeldt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Sporre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hillevi","family":"Leskinen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"S\u00f6derholm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lovisa","family":"Wennstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per Anders","family":"Broliden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Deneberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Espman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"von Bahr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5217-3235","authenticated-orcid":false,"given":"Martin","family":"J\u00e4dersten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"issue":"13","key":"11171_CR1","doi-asserted-by":"publisher","first-page":"4317","DOI":"10.1182\/blood-2002-03-0801","volume":"100","author":"BM Svahn","year":"2002","unstructured":"Svahn BM, Remberger M, Myrb\u00e4ck KE, Holmberg K, Eriksson B, Hentschke P et al (2002) Home care during the pancytopenic phase after allogeneic hematopoietic stem cell transplantation is advantageous compared with hospital care. Blood 100(13):4317\u20134324. https:\/\/doi.org\/10.1182\/blood-2002-03-0801","journal-title":"Blood"},{"key":"11171_CR2","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2021.106756","volume":"112","author":"KH N\u00f8rskov","year":"2022","unstructured":"N\u00f8rskov KH, Fridthjof K, Kampmann P, D\u00fcnweber A, Andersen CL, Renaberg T et al (2022) A national Danish proof of concept on feasibility and safety of home -based intensive chemotherapy in patients with acute myeloid leukemia. Leuk Res 112. https:\/\/doi.org\/10.1016\/j.leukres.2021.106756","journal-title":"Leuk Res"},{"issue":"1","key":"11171_CR3","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1080\/10428194.2020.1821008","volume":"62","author":"AB Halpern","year":"2021","unstructured":"Halpern AB, Othus M, Howard NP, Hendrie PC, Percival MEM, Scott BL et al (2021) Comparison of outpatient care following intensive induction versus post-remission chemotherapy for adults with acute myeloid leukemia and other high-grade myeloid neoplasms. Leuk Lymphoma 62(1):234\u2013238. https:\/\/doi.org\/10.1080\/10428194.2020.1821008","journal-title":"Leuk Lymphoma"},{"issue":"3","key":"11171_CR4","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1002\/jha2.208","volume":"2","author":"E Hernlund","year":"2021","unstructured":"Hernlund E, Redig J, Paulsson B, Rangert Derolf \u00c5, H\u00f6glund M, Vertuani S et al (2021) Socioeconomic cost of AML in Sweden-a population-based study using multiple nation-wide registers. EJHaem 2(3):385\u2013393. https:\/\/doi.org\/10.1002\/jha2.208","journal-title":"EJHaem"},{"issue":"32","key":"11171_CR5","doi-asserted-by":"publisher","first-page":"3609","DOI":"10.2217\/fon-2022-0706","volume":"18","author":"D Huggar","year":"2022","unstructured":"Huggar D, Knoth RL, Copher R, Cao Z, Lipkin C, McBride A et al (2022) Economic burden in US patients with newly diagnosed acute myeloid leukemia receiving intensive induction chemotherapy. Future Oncol 18(32):3609\u20133621. https:\/\/doi.org\/10.2217\/fon-2022-0706","journal-title":"Future Oncol"},{"issue":"1","key":"11171_CR6","doi-asserted-by":"publisher","DOI":"10.4084\/MJHID.2020.009","volume":"12","author":"BA Hansen","year":"2020","unstructured":"Hansen BA, Wendelbo \u00d8, Bruserud \u00d8, Hemsing AL, Mosevoll KA, Reikvam H (2020) Febrile neutropenia in acute leukemia. Epidemiology, etiology, pathophysiology and treatment. Mediterr J Hematol Infect Dis 12(1). https:\/\/doi.org\/10.4084\/MJHID.2020.009","journal-title":"Mediterr J Hematol Infect Dis"},{"issue":"4","key":"11171_CR7","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1111\/j.1600-0609.2009.01397.x","volume":"84","author":"T M\u00f8ller","year":"2010","unstructured":"M\u00f8ller T, Nielsen OJ, Welinder P, D\u00fcnweber A, Hjerming M, Moser C et al (2010) Safe and feasible outpatient treatment following induction and consolidation chemotherapy for patients with acute leukaemia. Eur J Haematol 84(4):316\u2013322. https:\/\/doi.org\/10.1111\/j.1600-0609.2009.01397.x","journal-title":"Eur J Haematol"},{"issue":"5","key":"11171_CR8","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1111\/bjh.15249","volume":"181","author":"KS Fridthjof","year":"2018","unstructured":"Fridthjof KS, Kampmann P, D\u00fcnweber A, G\u00f8rl\u00f8v JS, Nex\u00f8 C, Friis LS et al (2018) Systematic patient involvement for homebased outpatient administration of complex chemotherapy in acute leukemia and lymphoma. Br J Haematol 181(5):637\u2013641. https:\/\/doi.org\/10.1111\/bjh.15249","journal-title":"Br J Haematol"},{"issue":"1","key":"11171_CR9","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1111\/j.1600-0609.1995.tb01620.x","volume":"54","author":"GJ Ruiz-Arg\u00fcelles","year":"1995","unstructured":"Ruiz-Arg\u00fcelles GJ, Apreza-Molina MG, Alem\u00e1n-Hoey DD, G\u00f3mez-Almaguer D, Mar\u00edn-L\u00f3pez A, Mercado-D\u00edaz L (1995) Outpatient supportive therapy after induction to remission therapy in adult acute myelogenous leukaemia (AML) is feasible: a multicentre study. Eur J Haematol 54(1):18\u201320. https:\/\/doi.org\/10.1111\/j.1600-0609.1995.tb01620.x","journal-title":"Eur J Haematol"},{"issue":"6","key":"11171_CR10","doi-asserted-by":"publisher","first-page":"914","DOI":"10.3324\/haematol.2011.040220","volume":"96","author":"RB Walter","year":"2011","unstructured":"Walter RB, Lee SJ, Gardner KM, Chai X, Shannon-Dorcy K, Appelbaum FR et al (2011) Outpatient management following intensive induction chemotherapy for myelodysplastic syndromes and acute myeloid leukemia: a pilot study. Haematologica 96(6):914\u2013917. https:\/\/doi.org\/10.3324\/haematol.2011.040220","journal-title":"Haematologica"},{"issue":"7","key":"11171_CR11","doi-asserted-by":"publisher","first-page":"1246","DOI":"10.1093\/annonc\/mdm112","volume":"18","author":"TY Halim","year":"2007","unstructured":"Halim TY, Song KW, Barnett MJ, Forrest DL, Hogge DE, Nantel SH et al (2007) Positive impact of selective outpatient management of high-risk acute myelogenous leukemia on the incidence of septicemia. Ann Oncol 18(7):1246\u20131252. https:\/\/doi.org\/10.1093\/annonc\/mdm112","journal-title":"Ann Oncol"},{"issue":"3","key":"11171_CR12","doi-asserted-by":"publisher","first-page":"339","DOI":"10.3109\/10428190109064590","volume":"42","author":"DS Allan","year":"2001","unstructured":"Allan DS, Buckstein R, Imrie KR (2001) Outpatient supportive care following chemotherapy for acute myeloblastic leukemia. Leuk Lymphoma 42(3):339\u2013346. https:\/\/doi.org\/10.3109\/10428190109064590","journal-title":"Leuk Lymphoma"},{"issue":"8","key":"11171_CR13","doi-asserted-by":"publisher","first-page":"1120","DOI":"10.1001\/jamaoncol.2015.2969","volume":"1","author":"JE Vaughn","year":"2015","unstructured":"Vaughn JE, Othus M, Powell MA, Gardner KM, Rizzuto DL, Hendrie PC et al (2015) Resource utilization and safety of outpatient management following intensive induction or salvage chemotherapy for acute myeloid leukemia or myelodysplastic syndrome: a nonrandomized clinical comparative analysis. JAMA Oncol 1(8):1120\u20131127. https:\/\/doi.org\/10.1001\/jamaoncol.2015.2969","journal-title":"JAMA Oncol"},{"issue":"9","key":"11171_CR14","first-page":"814","volume":"84","author":"C Girmenia","year":"1999","unstructured":"Girmenia C, Alimena G, Latagliata R, Morano SG, Celesti F, Coppola L et al (1999) Out-patient management of acute myeloid leukemia after consolidation chemotherapy. Role of a hematologic emergency unit. Haematologica 84(9):814\u2013819","journal-title":"Haematologica"},{"issue":"30","key":"11171_CR15","doi-asserted-by":"publisher","first-page":"3977","DOI":"10.1200\/JCO.2011.35.0884","volume":"29","author":"JA Talcott","year":"2011","unstructured":"Talcott JA, Yeap BY, Clark JA, Siegel RD, Loggers ET, Lu C et al (2011) Safety of early discharge for low-risk patients with febrile neutropenia: a multicenter randomized controlled trial. J Clin Oncol 29(30):3977\u20133983. https:\/\/doi.org\/10.1200\/JCO.2011.35.0884","journal-title":"J Clin Oncol"},{"issue":"2","key":"11171_CR16","first-page":"215","volume":"91","author":"H Cherif","year":"2006","unstructured":"Cherif H, Johansson E, Bj\u00f6rkholm M, Kalin M (2006) The feasibility of early hospital discharge with oral antimicrobial therapy in low risk patients with febrile neutropenia following chemotherapy for hematologic malignancies. Haematologica 91(2):215\u2013222","journal-title":"Haematologica"},{"issue":"3","key":"11171_CR17","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1016\/s0002-9343(99)80367-2","volume":"98","author":"IA Malik","year":"1995","unstructured":"Malik IA, Khan WA, Karim M, Aziz Z, Khan MA (1995) Feasibility of outpatient management of fever in cancer patients with low-risk neutropenia: results of a prospective randomized trial. Am J Med 98(3):224\u2013231. https:\/\/doi.org\/10.1016\/s0002-9343(99)80367-2","journal-title":"Am J Med"},{"issue":"25","key":"11171_CR18","doi-asserted-by":"publisher","first-page":"4129","DOI":"10.1200\/JCO.2005.03.9909","volume":"24","author":"J Klastersky","year":"2006","unstructured":"Klastersky J, Paesmans M, Georgala A, Muanza F, Plehiers B, Dubreucq L et al (2006) Outpatient oral antibiotics for febrile neutropenic cancer patients using a score predictive for complications. J Clin Oncol 24(25):4129\u20134134. https:\/\/doi.org\/10.1200\/JCO.2005.03.9909","journal-title":"J Clin Oncol"},{"issue":"14","key":"11171_CR19","doi-asserted-by":"publisher","first-page":"1443","DOI":"10.1200\/JCO.2017.77.6211","volume":"36","author":"RA Taplitz","year":"2018","unstructured":"Taplitz RA, Kennedy EB, Bow EJ, Crews J, Gleason C, Hawley DK et al (2018) Outpatient management of fever and neutropenia in adults treated for malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America clinical practice guideline update. J Clin Oncol 36(14):1443\u20131453. https:\/\/doi.org\/10.1200\/JCO.2017.77.6211","journal-title":"J Clin Oncol"},{"issue":"suppl 5","key":"11171_CR20","doi-asserted-by":"publisher","first-page":"v111","DOI":"10.1093\/annonc\/mdw325","volume":"27","author":"J Klastersky","year":"2016","unstructured":"Klastersky J, de Naurois J, Rolston K, Rapoport B, Maschmeyer G, Aapro M et al (2016) Management of febrile neutropaenia: ESMO Clinical practice guidelines. Ann Oncol Off J Eur Soc Med Oncol 27(suppl 5):v111\u2013v118. https:\/\/doi.org\/10.1093\/annonc\/mdw325","journal-title":"Ann Oncol Off J Eur Soc Med Oncol"},{"key":"11171_CR21","unstructured":"R Core Team (2024). _R: a language and environment for statistical computing_. R Foundation for Statistical Computing, Vienna, Austria. <https:\/\/www.R-project.org\/>."},{"issue":"12","key":"11171_CR22","doi-asserted-by":"publisher","first-page":"658","DOI":"10.1159\/000322209","volume":"33","author":"L Eisele","year":"2010","unstructured":"Eisele L, G\u00fcnther F, Ebeling P, Nabring J, D\u00fchrsen U, D\u00fcrig J (2010) Outpatient management of acute myeloid leukemia after intensive consolidation chemotherapy is feasible and reduces hospital treatment costs. Onkologie 33(12):658\u2013664. https:\/\/doi.org\/10.1159\/000322209","journal-title":"Onkologie"},{"issue":"6","key":"11171_CR23","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD008238.pub3","volume":"2012","author":"R Gurion","year":"2012","unstructured":"Gurion R, Belnik-Plitman Y, Gafter-Gvili A, Paul M, Vidal L, Ben-Bassat I et al (2012) Colony-stimulating factors for prevention and treatment of infectious complications in patients with acute myelogenous leukemia. Cochrane Database Syst Rev 2012(6). https:\/\/doi.org\/10.1002\/14651858.CD008238.pub3","journal-title":"Cochrane Database Syst Rev"},{"issue":"3","key":"11171_CR24","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1016\/j.ajic.2017.08.021","volume":"46","author":"S Kalluru","year":"2018","unstructured":"Kalluru S, Eggers S, Barker A, Shirley D, Sethi AK, Sengupta S et al (2018) Risk factors for infection with multidrug-resistant organisms in Haryana, India. Am J Infect Control 46(3):341\u2013345. https:\/\/doi.org\/10.1016\/j.ajic.2017.08.021","journal-title":"Am J Infect Control"},{"key":"11171_CR25","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2024.103760","volume":"86","author":"Y Garcia-Parejo","year":"2025","unstructured":"Garcia-Parejo Y, Gonzalez-Rubio J, Garcia Guerrero J, Gomez-Juarez Sango A, Cantero Escribano JM, Najera A (2025) Risk factors for colonisation by multidrug-resistant bacteria in critical care units. Intensive Crit Care Nurs 86. https:\/\/doi.org\/10.1016\/j.iccn.2024.103760","journal-title":"Intensive Crit Care Nurs"},{"issue":"12","key":"11171_CR26","doi-asserted-by":"publisher","first-page":"1826","DOI":"10.3324\/haematol.2013.091025","volume":"98","author":"D Averbuch","year":"2011","unstructured":"Averbuch D, Orasch C, Cordonnier C, Livermore DM, Mikulska M, Viscoli C et al (2011) European guidelines for empirical antibacterial therapy for febrile neutropenic patients in the era of growing resistance: summary of the 2011 4th European Conference on Infections in Leukemia. Haematologica 98(12):1826\u20131835. https:\/\/doi.org\/10.3324\/haematol.2013.091025","journal-title":"Haematologica"},{"key":"11171_CR27","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(25)00619-X","author":"D Averbuch","year":"2025","unstructured":"Averbuch D, Vanbiervliet Y, Baccelli F, Mikulska M, Neofytos D, Garcia-Vidal C et al (2025) Empirical and targeted antimicrobial therapy in patients with febrile neutropenia and haematological malignancy or after haematopoietic cell transplantation: recommendations from the 10th European conference on infections in leukaemia. Lancet Infect Dis. https:\/\/doi.org\/10.1016\/S1473-3099(25)00619-X","journal-title":"Lancet Infect Dis"}],"container-title":["Supportive Care in Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-026-11171-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00520-026-11171-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00520-026-11171-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:48:50Z","timestamp":1792086530000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00520-026-11171-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,10]]},"references-count":27,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["11171"],"URL":"https:\/\/doi.org\/10.1007\/s00520-026-11171-2","relation":{},"ISSN":["0941-4355","1433-7339"],"issn-type":[{"value":"0941-4355","type":"print"},{"value":"1433-7339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,10]]},"assertion":[{"value":"24 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This research complies with the precept of the Declaration of Helsinki. Ethical approval for the retrospective analyses was obtained by the Swedish Ethical Review Authority (Dnr 2024-07172-01). The need for informed consent was waived in the ethics approval by the Swedish Ethical Review Authority.","order":1,"name":"Ethics","label":"Ethics approval and informed consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"954"}}